Individual provider Active NPI

Courtney Harley, ANP

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1003361049
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209014711 Issued in IL
Practice address
420 NE Glen Oak Ave Ste 401
Peoria, IL 61603
Phone
(309) 676-8123
Fax
(309) 676-8455
NPI assigned
Aug 19, 2016
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209014711 IL Primary
Family Nurse Practitioner 363LF0000X 209014711 IL

Addresses

Primary practice location

420 NE Glen Oak Ave Ste 401
Peoria, IL 61603

Mailing address

420 NE Glen Oak Ave
Ste 401
Peoria, IL 61603-3168
Phone (815) 526-2497

Other practice location 1

530 Park Ave East, Ste 403
Princeton, IL 61356
Phone (309) 676-8123

Other practice location 2

1050 E. Norris Dr., Suite 2B
Ottawa, IL 61350
Phone (309) 676-8123

Other practice location 3

920 West St, Ste 212
Peru, IL 61354
Phone (309) 676-8123

Other practice location 4

1401 E. 12th
Mendota, IL 61342
Phone (309) 676-8123

Other practice location 5

101 West 2nd St
Dixon, IL 61021
Phone (309) 517-3036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031000688 IL Practitioner - Nurse Practitioner 6709164536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renalcare Associates, S.C.Group PAC ID 7012818347, 48 clinicians

Practice addresses (Care Compare)

920 W St
Suite 212
Peru, IL 61354-2769
Phone (309) 676-8123

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renalcare Associates, S.C. Nurse Practitioner CurrentSince Nov 24, 2025 Accepting new patients
Illinois Valley Surgical Associates, SC PastSince Nov 1, 2002 Accepting new patients

Locations

101 W 2nd St
Dixon, IL 61021
Phone (815) 284-0555

1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461

1050 E Norris Dr
Ste 2B
Ottawa, IL 61350
Phone (815) 431-0785

1050 E Norris Dr
Ste 2C
Ottawa, IL 61350
Phone (815) 431-0785

420 NE Glen Oak Ave
Ste 401
Peoria, IL 61603
Phone (309) 624-9259

920 West St
Ste 212
Peru, IL 61354
Phone (309) 680-5000

530 Park Ave E
Ste 403
Princeton, IL 61356
Phone (815) 224-1610

Interoperability endpoints

  • Direct secure messaging: charley223606@direct.edward.org
  • Direct secure messaging: charley84707@direct.acumenmd.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1003361049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE",
            "address_2": "STE 401",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033168",
            "telephone_number": "815-526-2497",
            "fax_number": "309-676-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE STE 401",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61603",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Park Ave East, Ste 403",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "IL",
            "postal_code": "61356",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 E. Norris Dr., Suite 2B",
            "address_purpose": "LOCATION",
            "city": "Ottawa",
            "state": "IL",
            "postal_code": "61350",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 West St, Ste 212",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IL",
            "postal_code": "61354",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 E. 12th",
            "address_purpose": "LOCATION",
            "city": "Mendota",
            "state": "IL",
            "postal_code": "61342",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 West 2nd St",
            "address_purpose": "LOCATION",
            "city": "Dixon",
            "state": "IL",
            "postal_code": "61021",
            "country_code": "US",
            "telephone_number": "309-517-3036",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "COURTNEY",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014711",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.