Individual provider Active NPI

Christin Demierre, FNP

  • Family Nurse Practitioner
  • Bourbonnais, IL
National Provider Identifier
1780123091
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015178 Issued in IL
Practice address
1615 N Convent St Ste 1
Bourbonnais, IL 60914-1081
Phone
(815) 937-5200
Fax
(815) 937-2063
NPI assigned
Feb 20, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Diseases Consultants of Kankakee SC 14 clinicians

Practice addresses (Care Compare)

1615 N Convent St
Suite 1
Bourbonnais, IL 60914-1081
Phone (815) 937-5200

Hospital & facility affiliations

  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
  • Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155

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
I20170426002108 IL Practitioner - Nurse Practitioner 6709163983 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015178ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Apr 17, 2017 Accepting new patients
Digestive Diseases Consultants of Kankakee, SC CurrentSince Jun 1, 2023 Accepting new patients
Associates of Integrated Medicine LTD. CurrentSince Nov 1, 2017 Accepting new patients
Riverside Health System CurrentSince Apr 17, 2017 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

1615 N Convent St
Ste 1
Bourbonnais, IL 60914
Phone (815) 602-8253

350 N Wall St
Ste B302
Kankakee, IL 60901
Phone (815) 329-6500

1490 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-7693

1490 E Walnut St
Watseka, IL 60970
Phone (815) 432-0250

700 E Ogden Ave
Ste 202
Westmont, IL 60559
Phone (630) 528-3215

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015178 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

1615 N Convent St Ste 1
Bourbonnais, IL 60914-1081

Mailing address

1615 N Convent St Ste 1
Bourbonnais, IL 60914-1081
Phone (815) 937-5200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 2, 2025.

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1780123091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 N CONVENT ST STE 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141081",
            "telephone_number": "815-937-5200",
            "fax_number": "815-937-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 N CONVENT ST STE 1",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141081",
            "telephone_number": "815-937-5200",
            "fax_number": "815-937-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIERRE",
        "first_name": "CHRISTIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.