Individual provider Active NPI

Jennifer Van Autreve, FNP-BC

  • Family Nurse Practitioner
  • Washington, IL
National Provider Identifier
1033864061
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209022820 Issued in IL
Practice address
1986 Freedom Pkwy
Washington, IL 61571-9468
Phone
(309) 308-5100
NPI assigned
Feb 17, 2022
Last updated
Feb 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209022820 IL Primary

Addresses

Primary practice location

1986 Freedom Pkwy
Washington, IL 61571-9468

Mailing address

102 Joseph CT
Washington, IL 61571-4046
Phone (309) 648-3542

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
I20220607000072 IL Practitioner - Nurse Practitioner 5698153427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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)

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-8156

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

8800 State Route 91
Peoria, IL 61615-9473
Phone (309) 683-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209022820ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 1, 2022 Accepting new patients
Cardinal Medical Group, LTD. PastSince Feb 24, 2022 Accepting new patients

Locations (25 of 27)

508 Iaa Dr
Bloomington, IL 61701
Phone (309) 451-2080

2043 S Neil St
Champaign, IL 61820
Phone (217) 337-3852

1 N Logan Ave
Danville, IL 61832
Phone (217) 554-6827

3653 N Vermilion St
Danville, IL 61832
Phone (217) 554-6827

133 Spinder Dr
Ste 4015
East Peoria, IL 61611

2917 W 95th St
Evergreen Park, IL 60805
Phone (708) 907-4355

2779 Volunteer Dr
Ste 201
Galesburg, IL 61401
Phone (309) 345-9400

3315 W 115th St
Unit C
Merrionette Park, IL 60803
Phone (708) 907-4355

1715 N Division St
Ste 4D
Morris, IL 60450

1715 N Division St
Ste 4D5E
Morris, IL 60450
Phone (815) 431-3410

1715 N Division St
Ste 5E
Morris, IL 60450

435 Maxine Dr
Morton, IL 61550
Phone (309) 263-2424

1730 Bradford Ln
Normal, IL 61761
Phone (309) 451-2080

211 Greenbriar Dr
Normal, IL 61761
Phone (309) 268-9807

5660 W 95th St
Ste 1
Oak Lawn, IL 60453
Phone (708) 499-2273

6356 W 95th St
Oak Lawn, IL 60453
Phone (708) 907-4355

2911 Columbus St
Ottawa, IL 61350
Phone (815) 431-3410

2301 Court St
Pekin, IL 61554
Phone (303) 308-5100

10408 N Centerway Dr
Ste C
Peoria, IL 61615

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

3626 N Sheridan Rd
Peoria, IL 61604

5114 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 655-2431

5209 W War Memorial Dr
Peoria, IL 61615

5905 N Prospect Rd
Peoria, IL 61614

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1033864061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 JOSEPH CT",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615714046",
            "telephone_number": "309-648-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1986 FREEDOM PKWY",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719468",
            "telephone_number": "309-308-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN AUTREVE",
        "first_name": "JENNIFER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

Verify at the official NPI Registry.