Shannon Vanzummeren, APN
Individual provider Active NPI Family Nurse Practitioner · Oquawka, IL
NPI 1205202074 · NPPES record last updated Nov 18, 2025
Key facts
- NPI
- 1205202074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.013114 (IL)
- Practice address
- 1204 Highway 164 E
PO Box 198
Oquawka, IL 61469-6146 - Phone
- (309) 867-2202
- NPI assigned
- Aug 17, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henderson County Rural Health Center, Inc
Practice addresses (Care Compare)
101 S Division St
Stronghurst, IL 61480-5033
Phone (309) 924-1381
1204 Hwy 164 E
Oquawka, IL 61469-3204
Phone (309) 924-2414
230 S Main St
Monmouth, IL 61462-2160
Phone (309) 924-2414
Hospital & facility affiliations
- Southeast Iowa Regional Medical Center
- Osf Holy Family Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241205003715 | IL | Practitioner - Nurse Practitioner | 7517275498 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.013114 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Henderson County Rural Health Center Inc | Current |
Accepting new patients | |
| Henderson County Rural Health Center Inc | Current |
Accepting new patients | |
| Henderson County Rural Health Center Inc | Past | Accepting new patients |
Locations
230 S Main St
Monmouth, IL 61462
Phone (309) 536-9024
1204 Highway 164 E
Oquawka, IL 61469
Phone (309) 924-2414
Interoperability endpoints
- svanzummeren792472@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.013114 | IL | Yes |
Addresses
Primary practice location
1204 Highway 164 E
PO Box 198
Oquawka, IL 61469-6146
Mailing address
PO Box 198
Oquawka, IL 61469-0198
Phone (309) 924-2414
Other practice location 1
230 S Main
PO Box 198
Monmouth, IL 61462
Phone (309) 924-2414
Other practice location 2
855 Illini Dr
Suite 304
Silvis, IL 61282-2907
Phone (309) 281-2120
Other practice location 3
101 S Division
PO Box 198
Stronghurst, IL 61469-6146
Phone (309) 924-2424
Other providers in Oquawka, IL
- Jessica Lynn McKee
- Shannon Kelly Miller
- North Henderson County Ambulance Service Inc.
- Crystal Ann Simpson
- Jordanne Twigg
All providers in Oquawka, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.