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MARY NEVILLE DNP, CPNP-AC
NPI 1104545482
Nurse Practitioner - Pediatrics, Critical Care in Peoria, IL

Active since August 22, 2022
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 267-8760 Get Directions Write a Review

NPPES record last updated: August 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Neville Dnp, Cpnp-ac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY NEVILLE DNP, CPNP-AC (NPI 1104545482) is an individual pediatrics, critical care provider in Peoria, Illinois, licensed in Illinois (209.025804) and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1104545482
Entity TypeIndividualFemale
Primary Taxonomy363LP0222X
Provider Legal NameMARY NEVILLECredential: DNP, CPNP-AC
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address945 E 2150 North RdDanvers, IL 61732-9018 · (309) 267-8760
Phone(309) 267-8760
Sole ProprietorNo
Enumeration DateAugust 22, 2022
NPPES CertifiedJuly 29, 2022
✔ NPI 1104545482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Pediatrics, Critical CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0222X
License✔ Licensed in IL · 209.025804
530 NE GLEN OAK AVE, Peoria, IL 61637
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ERIC TYLER AMPARAN MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2274
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Neville's NPI number?

The NPI number for Mary Neville is 1104545482. It was assigned to this individual provider in the NPPES registry on August 22, 2022.

Where is Mary Neville located?

Mary Neville practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 267-8760.

What is Mary Neville's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, Critical Care, with taxonomy code 363LP0222X.

When was this NPI record last updated?

The NPPES record for Mary Neville was last updated on August 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.