Maggie Johnson
Individual provider Active NPI Family Nurse Practitioner · Galesburg, IL
NPI 1407304397 · NPPES record last updated Jan 1, 2025
Key facts
- NPI
- 1407304397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209014744 (IL)
- Practice address
- 3333 N Seminary St
Galesburg, IL 61401-1251 - Phone
- (309) 344-3161
- Fax
- (309) 344-9404
- NPI assigned
- Sep 20, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
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 |
|---|---|---|---|---|
| I20161215001332 | IL | Practitioner - Nurse Practitioner | 2567742240 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209014744 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Mary Medical Center | Current |
Accepting new patients | |
| Methodist Medical Center of Illinois | Nurse Practitioner | Current |
Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current |
Accepting new patients | |
| Epss LLC - Central Series | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Epss Peoria LLC | Current |
Accepting new patients | |
| Path Lab Diagnostic Services, LLC | Current | Accepting new patients | |
| Carle Health Care Incorporated | Current |
Accepting new patients | |
| St Mary Medical Center | Current |
Accepting new patients | |
| St Mary Medical Center | Nurse Practitioner | Past | Accepting new patients |
| Methodist Medical Center of Illinois | Past | Accepting new patients |
Locations
3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161
695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131
525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611
600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151
112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209014744 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209014744 | IL | Yes |
Addresses
Primary practice location
3333 N Seminary St
Galesburg, IL 61401-1251
Mailing address
3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161
Other providers in Galesburg, IL
- Jeffrey L. Hayden, D.C., P.C.
- Jet Air Inc.
- Denise M Johnson-Dechow
- Crystal Johnson
- Jazmin Nicole Johnson
- Marilou A Johnson
- Michelle L. Johnson
- Natalie Johnson
- Rachel Marie Johnson
- Laquita Dale Jones
All providers in Galesburg, 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 Jan 1, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.