Individual provider Active NPI

Emily K Snow, FNP-C

  • Family Nurse Practitioner
  • Streator, IL
National Provider Identifier
1629703079
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.025541 Issued in IL
Practice address
111 Spring St
Streator, IL 61364-3332
Phone
(815) 673-2311
NPI assigned
Jul 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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 209.025541 IL Primary

Addresses

Primary practice location

111 Spring St
Streator, IL 61364-3332

Mailing address

111 Spring St
Streator, IL 61364-3332
Phone (815) 672-4587

Other names 1

  • Emily Dikeman Former name

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
I20220927001345 IL Practitioner - Nurse Practitioner 9436535523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

111 Spring St
FL 4
Streator, IL 61364-3332
Phone (815) 672-4587

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.025541ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Sep 1, 2022 Accepting new patients
Saint James Hospital CurrentSince Sep 1, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Saint James Hospital Past Accepting new patients

Locations

111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

Organizations & group practices 4

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 3

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": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1629703079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SPRING ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613643332",
            "telephone_number": "815-672-4587",
            "fax_number": "815-673-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SPRING ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613643332",
            "telephone_number": "815-673-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "EMILY",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "DIKEMAN",
            "credential": "EMILY RICHARDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Streator, IL

Sources for this page

Verify at the official NPI Registry.