Individual provider Active NPI

Ryan Charles Scott Whitesell, RN-FNP

  • Registered Nurse
  • Watseka, IL
National Provider Identifier
1154287571
Registry record updated Jan 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041435040 Issued in IL
Practice address
1490 E Walnut St Ste a
Watseka, IL 60970-1833
Phone
(815) 432-7693
NPI assigned
Dec 30, 2025
Last updated
Jan 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2026

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 209034397 IL
Registered Nurse 163W00000X 041435040 IL Primary

Addresses

Primary practice location

1490 E Walnut St Ste a
Watseka, IL 60970-1833

Mailing address

350 N Wall St
Kankakee, IL 60901-2991
Phone (815) 935-7521

Other practice location 1

350 N Wall St
Kankakee, IL 60901-2991
Phone (815) 935-7521

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
I20260218001367 IL Practitioner - Nurse Practitioner 0749760742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041435040ILMDRegistered Nurse
209034397ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Jan 22, 2026 Accepting new patients
Riverside Health System CurrentSince Jan 22, 2026 Accepting new patients

Locations

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

1490 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-7693

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

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 1

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": "1767052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768089600000",
    "number": "1154287571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012991",
            "telephone_number": "815-935-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E WALNUT ST STE A",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701833",
            "telephone_number": "815-432-7693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Wall St",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609012991",
            "country_code": "US",
            "telephone_number": "815-935-7521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITESELL",
        "first_name": "RYAN",
        "middle_name": "CHARLES SCOTT",
        "name_prefix": "Mr.",
        "credential": "RN-FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-30",
        "last_updated": "2026-01-11",
        "certification_date": "2026-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209034397",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041435040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.