NPIMap

Individual provider Active NPI

Joan Marie Luckey, APRN,BC

  • Family Nurse Practitioner
  • Streator, IL
National Provider Identifier
1881767762
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-001759 Issued in IL
Practice address
109 E Elm St
Streator, IL 61364-2223
Phone
(815) 672-4587
Fax
(815) 673-3582
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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 209-001759 IL Primary

Addresses

Primary practice location

109 E Elm St
Streator, IL 61364-2223

Mailing address

109 E Elm St
Streator, IL 61364-2223
Phone (815) 672-4587

Other identifiers 1

IdentifierTypeStateIssuer
209-001759OtherILSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080411000656 IL Practitioner - Nurse Practitioner 7113004391 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

111 Spring St
FL 4
Streator, IL 61364-3332
Phone (815) 672-4587

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-001759ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa Regional Hospital & Healthcare Center Current Accepting new patients
Mendota Community Hospital CurrentSince Sep 24, 2023 Accepting new patients
Mendota Community Hospital CurrentSince Sep 24, 2023 Accepting new patients
Saint James Hospital CurrentSince Feb 24, 2021 Accepting new patients
Saint James Hospital CurrentSince Feb 24, 2021 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Sep 24, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Ottawa Regional Hospital & Healthcare Center Past Accepting new patients
Saint James Hospital Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

1640 1st Ave
Ottawa, IL 61350
Phone (815) 431-9208

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

1614 E Norris Dr
Ottawa, IL 61350
Phone (815) 433-1010

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

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587

111 Spring St
Fl 3
Streator, IL 61364
Phone (815) 434-4382

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1881767762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E ELM ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642223",
            "telephone_number": "815-672-4587",
            "fax_number": "815-673-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E ELM ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642223",
            "telephone_number": "815-672-4587",
            "fax_number": "815-673-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "credential": "APRN,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-001759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "209-001759",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

Verify at the official NPI Registry.