Individual provider Active NPI

Jennica M Finchum, PA-C

  • Physician Assistant
  • Peoria, IL
National Provider Identifier
1932382652
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003147 Issued in IL
Practice address
303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone
(309) 676-5546
NPI assigned
Dec 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-003147 IL Primary

Addresses

Primary practice location

303 N William Kumpf Blvd
Peoria, IL 61605-2507

Mailing address

303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone (309) 676-5546

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
I20090422000574 IL Practitioner - Physician Assistant 7911054309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
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)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-003147ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jul 17, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

3422 Court St
#A
Pekin, IL 61554
Phone (309) 477-6000

420 NE Glen Oak Ave
Ste 201
Peoria, IL 61603
Phone (309) 655-3800

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

420 NE Glen Oak Ave
Ste 301
Peoria, IL 61603
Phone (309) 655-7668

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

8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000

303 N William Kumpf Blvd
Peoria, IL 61605
Phone (309) 676-5546

Organizations & group practices 2

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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1932382652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N WILLIAM KUMPF BLVD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052507",
            "telephone_number": "309-676-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINCHUM",
        "first_name": "JENNICA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.