Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Pechacek, FNP-C

Individual provider Family Nurse Practitioner · NPI 1114356607

Derek Pechacek, FNP-C is a Nurse Practitioner in O Fallon, Illinois. Qualified in 2008, 18 years ago. Practices with Midwest Emergency Good Samaritan, Inc, a 29-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
18
Licensed in
IL
In the registry since
2013
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

320 E Highway 50
O Fallon, IL 62269-2704
Phone: (618) 624-3368
Fax: (618) 624-3387
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1300 N Market St, Sparta, IL 62286-1048 — (618) 443-4138

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209-010889 (IL)

Record details

NPI number1114356607
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedNovember 5, 2013
Last updated in NPPESMay 29, 2026
Certification dateMay 29, 2026
Mailing address2804 Lakeside Dr, Columbia, IL 62236-2681

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Midwest Emergency Good Samaritan, Inc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in O Fallon