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KATHLEEN MARIE HENDRICKS APN
NPI 1205312790
Nurse Practitioner in Peoria, IL

Active since July 17, 2018PECOS EnrolledAccepts Medicare Assignment
2809 W WILLOW KNOLLS DR, PEORIA, IL 61614(309) 692-6604 Get Directions Write a Review

NPPES record last updated: November 9, 2018. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 9, 2018, Sep 10, 2018, Aug 24, 2018 and 1 more (4 updates tracked since 2018).

About Kathleen Marie Hendricks Apn NPPES

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

KATHLEEN MARIE HENDRICKS APN (NPI 1205312790) is an individual nurse practitioner in Peoria, Illinois, licensed in Illinois (209017970) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1205312790
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKATHLEEN MARIE HENDRICKSCredential: APN
Location Address2809 W WILLOW KNOLLS DRPeoria, IL 61614
Mailing Address2809 W Willow Knolls DrPeoria, IL 61614-8517 · (309) 692-6604
Phone(309) 692-6604
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 17, 2018
Last NPPES UpdateNovember 9, 20184 updates tracked since enumeration
✔ NPI 1205312790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209017970
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 041.415297 (IL)
2809 W WILLOW KNOLLS DR, Peoria, IL 61614
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathleen Marie Hendricks Apn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022361237
PECOS Enrollment IDI20181105001339
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kathleen Hendricks reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Osf Multi-Specialty Group
2.0 mi
Internal Medicine
8600 N STATE ROUTE 91
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 2,944 clinicians in this Medicare group
NPI 1922445527 (309) 683-5050
Ottawa Regional Hospital & Healthcare Center
58 mi
General Acute Care Hospital
1100 E NORRIS DR
Ottawa, IL 61350
  • Reassigned Medicare billing, Illinois enrollment
  • 130 clinicians in this Medicare group
NPI 1306971080 (815) 433-3100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kathleen Hendricks's NPI number?

The NPI number for Kathleen Hendricks is 1205312790. It was assigned to this individual provider in the NPPES registry on July 17, 2018.

Where is Kathleen Hendricks located?

Kathleen Hendricks practices at 2809 W Willow Knolls Dr, Peoria, IL 61614. The listed phone number is (309) 692-6604.

What is Kathleen Hendricks's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kathleen Hendricks enrolled in Medicare?

Yes. Kathleen Hendricks is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kathleen Hendricks's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Hendricks reassigns Medicare benefits to 2 organizations: Osf Multi-Specialty Group (Peoria, IL) and Ottawa Regional Hospital & Healthcare Center (Ottawa, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Hendricks's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathleen Hendricks was last updated on November 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.