| Tracie R Kelly, APRN | |
|
1401 E 12th St, Mendota, IL 61342-9216 | |
| (815) 539-7461 | |
| Not Available |
| Full Name | Tracie R Kelly |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 1401 E 12th St, Mendota, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578197513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 277.004233 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 1848 |
| Entity Name | Osf Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Tracie R Kelly, APRN 110 8th St, Mendota, IL 61342-1846 Ph: (815) 878-8847 | Tracie R Kelly, APRN 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 539-7461 |
Jonathan Edwards, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1405 E 12th St, Suite 600, Mendota, IL 61342 Phone: 815-538-7200 Fax: 815-539-1444 | |
Dr. Kelly Ann Tonielli Davis, DNP APRN FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1201 Meriden St, Mendota, IL 61342 Phone: 815-538-1800 Fax: 815-538-4881 | |
Joy Preciado, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1405 E 12th St, Ste 300, Mendota, IL 61342 Phone: 815-539-3141 | |
Sharon Jones Burtlow, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1201 Meriden St, Mendota, IL 61342 Phone: 815-539-3739 Fax: 815-539-3753 | |
Stacy A Piller, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1405 E 12th St, Ste 600, Mendota, IL 61342 Phone: 815-538-7200 Fax: 815-539-1444 | |
Susan J Olsen, APRN FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 537 N 3850th Rd, Mendota, IL 61342 Phone: 815-993-7378 |