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DEVAN TYLER NELSON DO
NPI 1205630860
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since April 02, 2025
221 NE GLEN OAK AVE, PEORIA, IL 61636(309) 671-8308 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Devan Tyler Nelson Do NPPES

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

DEVAN TYLER NELSON DO (NPI 1205630860) is an individual student in an organized health care education/training program in Peoria, Illinois, licensed in (390200000X) and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1205630860
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDEVAN TYLER NELSONCredential: DO
Location Address221 NE GLEN OAK AVEPeoria, IL 61636-0001
Mailing Address1004 N 123rd StWauwatosa, WI 53226-3316 · (414) 943-6199
Phone(309) 671-8308
Sole ProprietorYes
Enumeration DateApril 2, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1205630860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed · 390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
221 NE GLEN OAK AVE, Peoria, IL 61636
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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.

BRYCE HAMAMOTO
Student in an Organized Health Care Education/Training Program
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
RIAZ SHAH MD
Internal Medicine
221 NE GLEN OAK AVE, SUITE 504
PEORIA, IL 61636
Peoria County (309) 672-5729
CENTRAL ILLINOIS RADIATION ONCOLOGY PHYSICIANS, LTD
Radiology (Radiation Oncology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5700
MIHAILO NIKOLIC
Nurse Anesthetist, Certified Registered
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5654
WAQAS ALI MD
Internal Medicine
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
ANNE LOOK APN
Nurse Practitioner (Acute Care)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-5522
DR. KENNETH STRUM M.D.
Anesthesiology
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 369-1761
DR. ANDREW BRIAN ARMSTRONG M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
221 NE GLEN OAK AVE
PEORIA, IL 61636
Peoria County (309) 672-4920

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 Devan Nelson's NPI number?

The NPI number for Devan Nelson is 1205630860. It was assigned to this individual provider in the NPPES registry on April 2, 2025.

Where is Devan Nelson located?

Devan Nelson practices at 221 NE Glen Oak Ave, Peoria, IL 61636. The listed phone number is (309) 671-8308.

What is Devan Nelson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Devan Nelson was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.