Jennifer Alice Berkley, APN
Individual provider Active NPI Family Nurse Practitioner · Normal, IL
NPI 1295088391 · NPPES record last updated Mar 29, 2017
Key facts
- NPI
- 1295088391
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209012345 (IL)
- Practice address
- 2200 Fort Jesse Rd
Normal, IL 61761-6286 - Phone
- (309) 661-6290
- NPI assigned
- Oct 26, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
2200 Fort Jesse Rd
Suite 110
Normal, IL 61761-6286
Phone (309) 661-6290
Hospital & facility affiliations
- Saint Francis Medical Center
- Saint James Hospital
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 |
|---|---|---|---|---|
| I20140129001866 | IL | Practitioner - Nurse Practitioner | 2062641723 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209012345 | IL | MD | Family Nurse Practitioner |
| 209009932 | IL | MD | Adult Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Healthcare System | Current | Accepting new patients | |
| St Joseph Medical Center | Current | Accepting new patients | |
| St Mary Medical Center | Current |
Accepting new patients | |
| St Mary Medical Center | Current |
Accepting new patients | |
| St Joseph Medical Center | Current |
Accepting new patients | |
| Osf Healthcare System | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| St Joseph Medical Center | Current |
Accepting new patients | |
| Osf Healthcare System | Current |
Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Mendota Community Hospital | Current |
Accepting new patients | |
| Path Lab Diagnostic Services, LLC | Current | Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients | |
| Bloomington Medical Laboratory Physicians, S.C. | Current | Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Current |
Accepting new patients | |
| Mendota Community Hospital | Current |
Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients |
Locations
3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161
801 Fox Run
Heyworth, IL 61745
Phone (309) 473-2069
1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141
1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825
2200 Fort Jesse Rd
Ste 110
Normal, IL 61761
Phone (309) 661-6250
2200 Fort Jesse Rd
Normal, IL 61761
Phone (309) 268-9300
1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Clinical Nurse Specialist | 364SA2200X | 209009932 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209012345 | IL | Yes |
Addresses
Primary practice location
2200 Fort Jesse Rd
Normal, IL 61761-6286
Mailing address
2200 Fort Jesse Rd
Normal, IL 61761-6286
Phone (309) 661-6290
Other providers in Normal, IL
- Denise E Bennett
- Andrew Benning
- Ashley Benson
- Jonathan David Benson
- Mark Andrew Benson
- Allison Berndt
- Kathy Jo Berry
- Deborah R Berryman
- Jay M Bersche
- Debbie Bessent
All providers in Normal, 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 Mar 29, 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.