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

Kelsey Marie Thacker

Individual provider Nurse Practitioner · NPI 1245765296

Kelsey Marie Thacker is a Nurse Practitioner in Mt Zion, Illinois. Qualified in 2016, 10 years ago. Practices with Decatur Orthopedic Center LLC, a 9-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2017

Practice location Address checks out

104 E Ashland Ave
Mt Zion, IL 62549-1271
Phone: (217) 864-2665
Fax: (217) 864-8042
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209015926 (IL)

Record details

NPI number1245765296
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 27, 2017
Last updated in NPPESApril 27, 2017
Mailing address104 Ashland Avenue, Mt. Zion, IL 62549

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Decatur Orthopedic Center Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mt Zion