Individual provider Active NPI

Shannon Lynn Hiller, APRN

  • Family Nurse Practitioner
  • Peru, IL
National Provider Identifier
1003572470
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023633 Issued in IL
Practice address
1650 Midtown Rd
Peru, IL 61354-1200
Phone
(815) 223-6843
NPI assigned
Nov 10, 2021
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209023633 IL
Family Nurse Practitioner 363LF0000X 209.023633 IL Primary

Addresses

Primary practice location

1650 Midtown Rd
Peru, IL 61354-1200

Mailing address

1322 W Madison St
Ottawa, IL 61350-2565
Phone (815) 822-1077

Other names 1

  • Shannon Whitley Former name

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
I20220329002554 IL Practitioner - Nurse Practitioner 1759777881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100

1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 227-5600

1614 E Norris Dr
OBGYN and Anti Coag
Ottawa, IL 61350-3681
Phone (815) 431-0435

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

920 W St
Suite 218 Ortho
Peru, IL 61354-2769
Phone (815) 431-5746

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.023633ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 20, 2022 Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

600 E 1st St
Spring Valley, IL 61362
Phone (815) 664-1477

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 3

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": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1003572470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 W MADISON ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613502565",
            "telephone_number": "815-822-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541200",
            "telephone_number": "815-223-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLER",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023633",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WHITLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peru, IL

Sources for this page

Verify at the official NPI Registry.