Individual provider Active NPI

Andrea A McLean, APRN, CNP

  • Family Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1265030019
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021682 Issued in IL
Practice address
1001 N Rivian Mtwy
Bloomington, IL 61705-6424
Phone
(309) 828-0806
Fax
(309) 827-5013
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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 209.021682 IL
Family Nurse Practitioner 363LF0000X 209021682 IL Primary

Addresses

Primary practice location

1001 N Rivian Mtwy
Bloomington, IL 61705-6424

Mailing address

802 Country LN
Bloomington, IL 61704-6263
Phone (309) 530-5144

Other practice location 1

2500 W Reynolds St # 205
Pontiac, IL 61764-9774
Phone (815) 842-4501

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
I20201030002455 IL Practitioner - Nurse Practitioner 2365852480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.021682ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Dec 1, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Nov 1, 2020 Accepting new patients
Saint James Hospital CurrentSince Dec 1, 2022 Accepting new patients

Locations

1001 Rivian Mtwy
Bloomington, IL 61705
Phone (309) 828-0806

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

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

124 SW Adams St
Fl 2
Peoria, IL 61602
Phone (309) 655-2850

2500 W Reynolds St
#205
Pontiac, IL 61764
Phone (815) 842-4501

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

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.

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1265030019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 COUNTRY LN",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046263",
            "telephone_number": "309-530-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N RIVIAN MTWY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617056424",
            "telephone_number": "309-828-0806",
            "fax_number": "309-827-5013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 W Reynolds St # 205",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "IL",
            "postal_code": "617649774",
            "country_code": "US",
            "telephone_number": "815-842-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "ANDREA",
        "middle_name": "A",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.021682",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.