Active NPI
Anastasia Peer-Drake
- Pediatric Nurse Practitioner
- Rockford, IL
National Provider Identifier
1417879727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209.036217
- Practice address
- 1100 Broadway
Rockford, IL 61104-1417 - Phone
- (815) 490-1600
- NPI assigned
- Jul 28, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209.036217 | IL | Primary |
Addresses
Primary practice location
1100 Broadway
Rockford, IL 61104-1417
Mailing address
1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1417879727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611022112",
"telephone_number": "815-490-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 BROADWAY",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611041417",
"telephone_number": "815-490-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEER-DRAKE",
"first_name": "ANASTASIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-28",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209.036217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
- Christine M Pedersen, MSPT
- Pediatric Associates of Rockford
- Pediatric Cardiology Associates of Northern Illinois SC
- Pediatric Dentistry of Northern Illinois LTD
- Pediatrix Medical Group of Illinois PC
- Kevin J Peifer, M.D.
- Pilar Romsos Peigh, MA, CCC/SLP
- Heidi Sue Pena, APRN
- Melinda Annette Pena, APNP
- Laura Penna, L.C.P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.