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

Melissa M Theobald, FNP

Individual provider Registered Nurse · NPI 1114763737

Melissa M Theobald, FNP is a Nurse Practitioner in Peoria, Illinois. Qualified in 2024, 2 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

3626 N Sheridan Rd
Peoria, IL 61604-1401
Phone: (309) 308-5100
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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 209030474 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 041362793 (IL)

Record details

NPI number1114763737
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedJuly 3, 2024
Last updated in NPPESOctober 23, 2024
Certification dateOctober 23, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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