Individual provider Active NPI

Michelle L Whitelow, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1932479664
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-009324 Issued in IL
Practice address
711 W John Gwynn Jr. Avenue
Peoria, IL 61605
Phone
(309) 680-7600
Fax
(309) 671-2188
NPI assigned
Jan 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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 209-009324 IL Primary

Addresses

Primary practice location

711 W John Gwynn Jr. Avenue
Peoria, IL 61605

Mailing address

2214 N University St
Peoria, IL 61604-3221
Phone (309) 680-7660

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
I20161028000113 IL Practitioner - Nurse Practitioner 6901036854 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Illinois LLCGroup PAC ID 2264747344, 38 clinicians

Practice addresses (Care Compare)

1530 N Randall Rd
Suite 210
Elgin, IL 60123-7879
Phone (224) 760-7322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-009324ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Family CurrentSince Sep 12, 2022 Accepting new patients
Applebaum Physiatry PLLC Family CurrentSince Oct 14, 2023 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 12, 2022 Accepting new patients
Chestnut Health of Illinois LLC CurrentSince Jun 21, 2024 Accepting new patients

Locations

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

2076 N Main St
Canton, IL 61520
Phone (309) 647-6090

5061 N Pulaski Rd
Chicago, IL 60630
Phone (773) 478-1186

1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322

2013 Midwest Rd
Oak Brook, IL 60523
Phone (630) 495-0220

1419 S Folkers Ave
Frnt
Peoria, IL 61605

1615 N North St
Peoria, IL 61604
Phone (309) 252-1020

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

811 S Griswold St
Peoria, IL 61605
Phone (309) 685-8390

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

711 W John H Gwynn Jr Ave
Peoria, IL 61605
Phone (309) 672-5650

128 S East St
Unit 1109
Crown Point, IN 46308

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.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1932479664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043221",
            "telephone_number": "309-680-7660",
            "fax_number": "309-681-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W JOHN GWYNN JR. AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61605",
            "telephone_number": "309-680-7600",
            "fax_number": "309-671-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELOW",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-009324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.