Individual provider Active NPI

Chelsea Krejci

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1043779861
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018999 Issued in IL
Practice address
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone
(309) 691-1069
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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 209018999 IL
Family Nurse Practitioner 363LF0000X 209018999 IL Primary

Addresses

Primary practice location

5409 N Knoxville Ave
Peoria, IL 61614-5069

Mailing address

4610 W Gladstone PL
Peoria, IL 61615-2825
Phone (309) 642-7120

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
I20190703000969 IL Practitioner - Nurse Practitioner 5698009165 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

508 Iaa Dr
Bloomington, IL 61701-2216
Phone (309) 451-2080

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209018999ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epss LLC - Central Series CurrentSince Aug 20, 2019 Accepting new patients
Epss Peoria LLC CurrentSince May 28, 2019 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 25, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

133 Spinder Dr
Ste 4015
East Peoria, IL 61611

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

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

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1043779861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 W GLADSTONE PL",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152825",
            "telephone_number": "309-642-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145069",
            "telephone_number": "309-691-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREJCI",
        "first_name": "CHELSEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018999",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.