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

Kimani Fitzgerald

Individual provider Family Nurse Practitioner · NPI 1740011154

Kimani Fitzgerald is a Nurse Practitioner in East Peoria, Illinois. Qualified in 2022, 4 years ago. Practices with Proctor Health Systems, a 132-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2024
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Practice location Address checks out

1000 Centennial Dr
East Peoria, IL 61611-4916
Phone: (309) 324-0880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209.029516 (IL)

Record details

NPI number1740011154
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 8, 2024
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024
Mailing address6224 N Talisman Ter, Peoria, IL 61615-2749

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Proctor Health Systems — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations14 on file with Medicare

Other providers in East Peoria