Tien T Pham, APN, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209017737 Issued in IL

Practice address

5405 N Knoxville Ave
Peoria, IL 61614-5016

Phone

(309) 589-2050

Fax

(309) 692-4730

NPI assigned

Oct 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

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)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Graham Hospital Association Hospital, Canton, IL, CCN 140001
• Graham Hospital Association Hospital, Canton, IL, CCN 141356
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  dba Physical Medicine & Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment NPD
• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Galesburg, IL
  • NPI 1962467670
  Medicare reassignment NPD
• Saint Francis Medical Center

  dba Saint Francis Home Health

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• St Mary Medical Center

  • Rural Health Clinic/Center
  • Galesburg, IL
  • NPI 1275234965
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Dang Home Infusion Pharmacy, LLC

  dba Vital Care of Peoria

  • Home Infusion Therapy Pharmacy
  • Peoria, IL
  • NPI 1851138374
  NPD (past)

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

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1154117521
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1912473273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-589-2050",
            "fax_number": "309-692-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-589-2050",
            "fax_number": "309-692-4730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1127 W Glen Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616144865",
            "country_code": "US",
            "telephone_number": "309-916-9100",
            "fax_number": "309-916-9099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TIEN",
        "middle_name": "T",
        "credential": "APN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric L. Pfeiffer, APN
• Benjamin R Pflederer, MD
• Robert A Pflederer, MD
• Timothy A Pflederer, MD
• Mary Pham
• Jubilee Phan, M.D.
• Jereme Pheasant, CRNA
• Casie Phegley, M.S. CCC-SLP/L
• Amy B Pheiffer, APN
• Nora Philbin, D.O

• Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.