Individual provider Active NPI

Janelle Fenski, APN

  • Family Nurse Practitioner
  • Pekin, IL
National Provider Identifier
1790154532
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.013156 Issued in IL
Practice address
19 Olt Ave
Pekin, IL 61554-6214
Phone
(309) 353-6301
NPI assigned
Sep 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.013156 IL Primary

Addresses

Primary practice location

19 Olt Ave
Pekin, IL 61554-6214

Mailing address

19 Olt Ave
Pekin, IL 61554-6214
Phone (309) 353-6301

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
I20151111001741 IL Practitioner - Nurse Practitioner 9739499336 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.013156ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pekin Prohealth Inc CurrentSince Oct 10, 2015 Accepting new patients
Proctor Health Systems CurrentSince Mar 1, 2023 Accepting new patients
Proctor Health Systems CurrentSince Mar 1, 2023 Accepting new patients

Locations

19 Olt Ave
Pekin, IL 61554
Phone (309) 353-6301

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1790154532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 OLT AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546214",
            "telephone_number": "309-353-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLT AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546214",
            "telephone_number": "309-353-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSKI",
        "first_name": "JANELLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.013156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

Verify at the official NPI Registry.