Individual provider Active NPI

Melanie Marie Hosbrough, MED. TATTOO ARTIST

  • Specialist
  • Peoria, IL
National Provider Identifier
1720707045
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
5901 N Prospect Rd Ste 106
Peoria, IL 61614-4395
Phone
(309) 885-2264
NPI assigned
Aug 22, 2022
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 14054 IL
Specialist 174400000X IL Primary

Addresses

Primary practice location

5901 N Prospect Rd Ste 106
Peoria, IL 61614-4395

Mailing address

5901 N Prospect Rd Ste 106
Peoria, IL 61614-4395
Phone (309) 885-2264

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

LicenseStateTypeSpecialty
14054ILMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1720707045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 N PROSPECT RD STE 106",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144395",
            "telephone_number": "309-885-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N PROSPECT RD STE 106",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144395",
            "telephone_number": "309-885-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSBROUGH",
        "first_name": "MELANIE",
        "middle_name": "MARIE",
        "credential": "MED. TATTOO ARTIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "14054",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 31, 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.

Verify at the official NPI Registry.