Individual provider Active NPI

Shannon L Egan, APRN,CNP

  • Family Nurse Practitioner
  • Galesburg, IL
National Provider Identifier
1043098445
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028961 Issued in IL
Practice address
3315 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 344-1000
NPI assigned
Sep 18, 2023
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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 209.028961 IL
Family Nurse Practitioner 363LF0000X 209028961 IL Primary

Addresses

Primary practice location

3315 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 345-9440

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
I20240113000732 IL Practitioner - Nurse Practitioner 9537511654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians
St Mary Medical CenterGroup PAC ID 8628038015, 52 clinicians

Practice addresses (Care Compare)

3315 N Seminary St
St 101
Galesburg, IL 61401-1251
Phone (309) 344-1000

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

3375 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 343-5114

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.028961ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center CurrentSince Jan 17, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
St. Mary Medical Center CurrentSince Jan 17, 2024 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 17, 2024 Accepting new patients
St Mary Medical Center Current Accepting new patients
St Mary Medical Center Past Accepting new patients
St Mary Medical Center Nurse Practitioner Past Accepting new patients

Locations

3315 N Seminary St
Galesburg, IL 61401
Phone (309) 344-1000

3315 N Seminary St
#101
Galesburg, IL 61401
Phone (309) 344-1000

3315 N Seminary St
Ste 206
Galesburg, IL 61401
Phone (309) 344-1000

3315 N Seminary St
Ste 207
Galesburg, IL 61401

3315 N Seminary St
Ste 208
Galesburg, IL 61401
Phone (309) 344-1000

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

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

Organizations & group practices 7

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1043098445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-345-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.028961",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.