Individual provider Active NPI

Christopher L. Deboe, BSN, RN

  • Family Nurse Practitioner
  • Granite City, IL
National Provider Identifier
1942078829
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.033277 Issued in IL
Practice address
50 Northgate Industrial Dr
Granite City, IL 62040-6805
Phone
(618) 877-4420
NPI assigned
Dec 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.033277 IL Primary
Registered Nurse 163W00000X 154117 MO
Registered Nurse 163W00000X 041420883 IL

Addresses

Primary practice location

50 Northgate Industrial Dr
Granite City, IL 62040-6805

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786

Other practice location 1

1 Hairpin Dr
Edwardsville, IL 62026-0001
Phone (618) 650-3956

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
I20260618001853 IL Practitioner - Nurse Practitioner 7416429675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1003 Martin Luther King Dr
Bloomington, IL 61701-1429

8 Crystal CT
Belleville, IL 62221-4622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041420883ILMDRegistered Nurse
154117MOMDRegistered Nurse
209.033277ILMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1942078829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORTHGATE INDUSTRIAL DR",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406805",
            "telephone_number": "618-877-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hairpin Dr",
            "address_purpose": "LOCATION",
            "city": "Edwardsville",
            "state": "IL",
            "postal_code": "620260001",
            "country_code": "US",
            "telephone_number": "618-650-3956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBOE",
        "first_name": "CHRISTOPHER",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-19",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.033277",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "154117",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041420883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

Verify at the official NPI Registry.