NPIMap

Individual provider Active NPI

Teresa Dawn Mejorado, PA-C

  • Physician Assistant
  • Bloomington, IL
National Provider Identifier
1518118140
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001992 Issued in IL
Practice address
3024 E Empire St Ste 3C
Bloomington, IL 61704-5402
Phone
(309) 556-7700
Fax
(309) 556-7785
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-001992 IL Primary

Addresses

Primary practice location

3024 E Empire St Ste 3C
Bloomington, IL 61704-5402

Mailing address

3024 E Empire St Ste 3C
Bloomington, IL 61704-5402
Phone (309) 556-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000764 IL Practitioner - Physician Assistant 2365415809 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healogics Specialty Physicians of Illinois, LLCGroup PAC ID 4486877511, 14 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Suite 210
Pontiac, IL 61764-9774
Phone (309) 661-6230

77 N Airlite St
Elgin, IL 60123-4912
Phone (847) 622-3407

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-001992ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
St Joseph Medical Center CurrentSince Jan 9, 2012 Accepting new patients
Carle Health Care Incorporated CurrentSince Feb 23, 2026 Accepting new patients
Francis C Lee, MD SC PastSince Jul 15, 2004 Accepting new patients
Carle Bromenn Medical Center Past Accepting new patients
Carle West Physician Group Inc Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
St Joseph Medical Center Past Accepting new patients

Locations

1505 Eastland Dr
Ste 1100
Bloomington, IL 61701
Phone (309) 663-2100

1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

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

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

2500 W Reynolds St
Ste 210
Pontiac, IL 61764
Phone (309) 661-6230

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1518118140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 E EMPIRE ST STE 3C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617045402",
            "telephone_number": "309-556-7700",
            "fax_number": "309-556-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 E EMPIRE ST STE 3C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617045402",
            "telephone_number": "309-556-7700",
            "fax_number": "309-556-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJORADO",
        "first_name": "TERESA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.