Individual provider Active NPI

Jesus Presiado, APRN

  • Family Nurse Practitioner
  • Rantoul, IL
National Provider Identifier
1376435685
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.032755 Issued in IL
Practice address
841 Broadmeadow Rd
Rantoul, IL 61866-2166
Phone
(218) 282-3010
NPI assigned
Jul 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.032755 IL Primary

Addresses

Primary practice location

841 Broadmeadow Rd
Rantoul, IL 61866-2166

Mailing address

404 Yalow Dr
Champaign, IL 61822-1154
Phone (217) 778-8121

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
I20250918000277 IL Practitioner - Nurse Practitioner 3870097371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

508 Iaa Dr
Bloomington, IL 61701-2216
Phone (309) 451-2080

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.032755ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Sep 8, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

133 Spinder Dr
East Peoria, IL 61611
Phone (309) 265-7287

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

841 Broadmeadow Rd
Rantoul, IL 61866
Phone (217) 282-3010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1376435685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 YALOW DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221154",
            "telephone_number": "217-778-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 BROADMEADOW RD",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618662166",
            "telephone_number": "218-282-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESIADO",
        "first_name": "JESUS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.032755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rantoul, IL

Sources for this page

Verify at the official NPI Registry.