Keith Christensen, APN, FNP
Individual provider Active NPI Family Nurse Practitioner · Peru, IL
NPI 1255844189 · NPPES record last updated Nov 14, 2017
Key facts
- NPI
- 1255844189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.016759 (IL)
- Practice address
- 1650 Midtown Rd
Peru, IL 61354-1200 - Phone
- (815) 664-5311
- NPI assigned
- Nov 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 19
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mendota Community Hospital
Practice addresses (Care Compare)
1650 Midtown Rd
Peru, IL 61354-1200
Phone (815) 538-1351
Hospital & facility affiliations
- Osf Saint Paul Medical Center
- Osf Saint Elizabeth MDL Ctr
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 |
|---|---|---|---|---|
| I20191127001370 | IL | Practitioner - Nurse Practitioner | 9133552466 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.016759 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint James Hospital | Current |
Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Current | Accepting new patients | |
| Osf Healthcare System | Current | Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Current |
Accepting new patients | |
| Osf Healthcare System | Current |
Accepting new patients | |
| Mendota Community Hospital | Current |
Accepting new patients | |
| Osf Healthcare System | Current |
Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients | |
| Mendota Community Hospital | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Past | Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Past | Accepting new patients | |
| Saint James Hospital | Past | Accepting new patients |
Locations
1405 E 12th St
Ste 600
Mendota, IL 61342
Phone (815) 538-7200
1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825
1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414
1640 1st Ave
Ottawa, IL 61350
Phone (815) 431-9208
1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224
124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850
1650 Midtown Rd
Peru, IL 61354
Phone (815) 220-1122
535 Park Ave E
Princeton, IL 61356
Phone (815) 875-4531
600 E 1st St
Spring Valley, IL 61362
Phone (815) 664-1477
111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.016759 | IL | Yes |
Addresses
Primary practice location
1650 Midtown Rd
Peru, IL 61354-1200
Mailing address
27661 W Drake Dr Apt 244
Channahon, IL 60410-8795
Phone (815) 735-1807
Other providers in Peru, IL
- Tricia Casford
- Lee Michael Ceresa
- Chicago Hearing LLC
- Dale R Chilson
- Catherine A Christensen
- Nicole Marie Chum
- City Center Physical Therapy - Peru, Inc.
- City Center Rehabilitation West - Inc.
- CMS & S LTD.
- Julie A Condie
All providers in Peru, 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 14, 2017. 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.