Individual provider Active NPI

Jessica L Schupp, APRN, CNP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1962960393
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018917 Issued in IL
Practice address
2265 W Altorfer Dr
Peoria, IL 61615-1807
Phone
(309) 683-7700
Fax
(309) 683-7752
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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 209018917 IL Primary

Addresses

Primary practice location

2265 W Altorfer Dr
Peoria, IL 61615-1807

Mailing address

2265 W Altorfer Dr
Peoria, IL 61615-1807
Phone (309) 683-7700

Other practice location 1

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

Other names 1

  • Jessica L McAllister Former name

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
I20190411000105 IL Practitioner - Nurse Practitioner 2769723295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2265 W Altorfer Dr
Peoria, IL 61615-1807
Phone (309) 683-7848

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
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Apr 15, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

2265 W Altorfer Dr
Peoria, IL 61615
Phone (309) 370-9323

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

1310 N Missouri Ave
Peoria, IL 61603
Phone (309) 308-3800

Organizations & group practices 3

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": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1962960393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 W ALTORFER DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151807",
            "telephone_number": "309-683-7700",
            "fax_number": "309-683-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 W ALTORFER DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151807",
            "telephone_number": "309-683-7700",
            "fax_number": "309-683-7752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 N Seminary St",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614011251",
            "country_code": "US",
            "telephone_number": "309-344-3161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MCALLISTER",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.