Individual provider Active NPI

Monica Lynn Interial, APN

  • Nurse Practitioner
  • Galesburg, IL
National Provider Identifier
1043909757
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027328 Issued in IL
Practice address
1377 W Main St
Galesburg, IL 61401-3315
Phone
(773) 641-8904
NPI assigned
May 8, 2023
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209027328 IL Primary

Addresses

Primary practice location

1377 W Main St
Galesburg, IL 61401-3315

Mailing address

1377 W Main St
Galesburg, IL 61401-3315
Phone (773) 641-8904

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
I20240528003161 IL Practitioner - Nurse Practitioner 1355783929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

3315 N Seminary St
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) 676-0766

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

Hospital & facility affiliations

  • St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
  • Osf Holy Family Medical Center Hospital, Monmouth, IL, CCN 141318
  • Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209027328ILMDNurse Practitioner
209024328ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince May 2, 2024 Accepting new patients

Locations

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

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

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

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

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

530 Park Ave E
Ste 303A
Princeton, IL 61356
Phone (815) 876-3179

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 and National Provider Directory roles.

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1043909757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 W MAIN ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614013315",
            "telephone_number": "773-641-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 W MAIN ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614013315",
            "telephone_number": "773-641-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTERIAL",
        "first_name": "MONICA",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.