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

Sandy Northcutt

Individual provider Medical-Surgical Registered Nurse · NPI 1174209704

Sandy Northcutt is a Nurse Practitioner in Peoria, Illinois. Qualified in 2023, 3 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2023
Specialties on file
2

Practice location Address checks out

124 SW Adams St
Peoria, IL 61602-1308
Phone: (888) 209-3761
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209.028107 (IL)
Medical-Surgical Registered Nurse Taxonomy 163WM0705X · Licence 041.310284 (IL)

Record details

NPI number1174209704
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 27, 2023
Last updated in NPPESSeptember 22, 2023
Certification dateSeptember 22, 2023
Mailing address252 N 45th Rd, Mendota, IL 61342-9427

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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