Active NPI
Melinda Henderson, C-FNP
- Pediatric Nurse Practitioner
- Peoria, IL
National Provider Identifier
1679516561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- Practice address
- 7801 N Knoxville Ave
Peoria, IL 61614-2076 - Phone
- (309) 692-6088
- NPI assigned
- Jun 14, 2006
- 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 | IL | Primary |
Addresses
Primary practice location
7801 N Knoxville Ave
Peoria, IL 61614-2076
Mailing address
5100 Reliable Parkway
Chicago, IL 60686-0001
Phone (309) 692-6088
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL01Q9 | Other | IL | JOHN DEERE |
| 073083 | Other | IL | HEALTH ALLIANCE |
| 472310 | Other | IL | HEALTHLINK |
| 7215059 | Other | IL | BCBS PPO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209001122 | IL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Peoria, IL
- NPI 1184670663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679516561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 RELIABLE PARKWAY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606860001",
"telephone_number": "309-692-6088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7801 N KNOXVILLE AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616142076",
"telephone_number": "309-692-6088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "MELINDA",
"credential": "C-FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "IL01Q9",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "073083",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "472310",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PPO",
"identifier": "7215059",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.