Individual provider Active NPI

Chris A Herbert, FNP

  • Family Nurse Practitioner
  • Dixon, IL
National Provider Identifier
1760022180
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209020686 Issued in IL
Practice address
403 E 1St St
Dixon, IL 61021-3187
Phone
(815) 288-5531
Fax
(815) 285-5558
NPI assigned
Jan 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 209020686 IL
Family Nurse Practitioner 363LF0000X 209020686 IL Primary

Addresses

Primary practice location

403 E 1St St
Dixon, IL 61021-3187

Mailing address

403 E 1St St
Dixon, IL 61021-3187
Phone (815) 288-5531

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
I20200219000471 IL Practitioner - Nurse Practitioner 8224465943 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 875-2811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209020686ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
KSB Medical Group, Inc. Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Katherine Shaw Bethea Hospital CurrentSince Jan 6, 2020 Accepting new patients
Osf Multi-Specialty Group CurrentSince Dec 12, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
KSB Medical Group, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Cardinal Medical Group, LTD. Past Accepting new patients

Locations

215 E 1st St
Ste 326
Dixon, IL 61021
Phone (815) 285-5800

403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629

215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

530 Park Ave E
Princeton, IL 61356
Phone (815) 875-2811

Organizations & group practices 6

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 1

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1760022180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213187",
            "telephone_number": "815-288-5531",
            "fax_number": "815-285-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213187",
            "telephone_number": "815-288-5531",
            "fax_number": "815-285-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "CHRIS",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "209020686",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.