Individual provider Active NPI

Zuzana Jackevicius Killam

  • Psychiatric/Mental Health Nurse Practitioner
  • Gillespie, IL
National Provider Identifier
1306584917
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209025228 Issued in IL
Practice address
109 E Maple St
Gillespie, IL 62033-1473
Phone
(217) 839-1526
Fax
(217) 839-1538
NPI assigned
May 24, 2022
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209025228 IL Primary

Addresses

Primary practice location

109 E Maple St
Gillespie, IL 62033-1473

Mailing address

205 Oakland Ave
Carlinville, IL 62626-1921
Phone (217) 854-3223

Other practice location 1

205 Oakland Ave
Carlinville, IL 62626-1921
Phone (217) 854-3223

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
I20220614003052 IL Practitioner - Nurse Practitioner 2264811645 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209025228ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Macoupin County Public Health Department CurrentSince May 13, 2022 Accepting new patients
Macoupin County Public Health Department CurrentSince May 13, 2022 Accepting new patients

Locations

1115 Morgan St
Carlinville, IL 62626
Phone (217) 854-3223

205 Oakland Ave
Carlinville, IL 62626
Phone (217) 839-7820

109 E Maple St
Gillespie, IL 62033
Phone (217) 839-1526

Interoperability endpoints

  • Direct secure messaging: zuzana.killam.d3.p30@direct.fhn-fqhc.nextgenshare.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1306584917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 OAKLAND AVE",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261921",
            "telephone_number": "217-854-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E MAPLE ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331473",
            "telephone_number": "217-839-1526",
            "fax_number": "217-839-1538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Oakland Ave",
            "address_purpose": "LOCATION",
            "city": "Carlinville",
            "state": "IL",
            "postal_code": "626261921",
            "country_code": "US",
            "telephone_number": "217-854-3223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLAM",
        "first_name": "ZUZANA",
        "middle_name": "JACKEVICIUS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209025228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillespie, IL

Sources for this page

Verify at the official NPI Registry.