Individual provider Active NPI

Anna Zofia Peek, FNP

  • Nurse Practitioner
  • Peru, IL
National Provider Identifier
1467920330
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209018444 Issued in IL
Practice address
1436 Midtown Rd
Peru, IL 61354-1271
Phone
(815) 220-3146
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209018444 IL Primary

Addresses

Primary practice location

1436 Midtown Rd
Peru, IL 61354-1271

Mailing address

103 Oak St
Spring Valley, IL 61362-2320
Phone (815) 343-4679

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
I20230815003523 IL Practitioner - Nurse Practitioner 5092199604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitas Health Services of Texas PAGroup PAC ID 7012160518, 4 clinicians

Practice addresses (Care Compare)

1040 4TH St
Peru, IL 61354-3610
Phone (877) 868-4827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Health Services of Texas, P.a. Nurse Practitioner CurrentSince Jul 31, 2023 Accepting new patients

Locations

1340 S Damen Ave
Ste 200
Chicago, IL 60608
Phone (312) 997-7200

1040 4th St
Peru, IL 61354
Phone (815) 220-0021

255 E 5th St
Ste 1050
Cincinnati, OH 45202

Organizations & group practices 1

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1467920330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 OAK ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613622320",
            "telephone_number": "815-343-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541271",
            "telephone_number": "815-220-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEK",
        "first_name": "ANNA",
        "middle_name": "ZOFIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

Verify at the official NPI Registry.