Individual provider Active NPI

Janet L. Collopy

  • Nurse Practitioner
  • Galesburg, IL
National Provider Identifier
1699855007
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041155451/209000357 Issued in IL
Practice address
3315 N Seminary St
Galesburg, IL 61401
Phone
(309) 344-1000
Fax
(309) 344-2405
NPI assigned
Oct 17, 2006
Last updated
Aug 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 041155451/209000357 IL Primary

Addresses

Primary practice location

3315 N Seminary St
Galesburg, IL 61401

Mailing address

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000

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
I20070426000446 IL Practitioner - Nurse Practitioner 9032215793

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041155451/209000357ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center CurrentSince May 1, 2007 Accepting new patients
Osf Healthcare System CurrentSince Aug 14, 2019 Accepting new patients
St Mary Medical Center Nurse Practitioner CurrentSince May 1, 2007 Accepting new patients
Osf Healthcare System CurrentSince Mar 4, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System CurrentSince Mar 4, 2016 Accepting new patients
Osf Healthcare System Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
St Mary Medical Center Current Accepting new patients

Locations

3315 N Seminary St
Galesburg, IL 61401
Phone (309) 344-1000

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

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

120 E Gale St
Williamsfield, IL 61489
Phone (309) 344-1000

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1699855007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-1000",
            "fax_number": "309-344-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "61401",
            "telephone_number": "309-344-1000",
            "fax_number": "309-344-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLOPY",
        "first_name": "JANET",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041155451/209000357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.