Marcus Mutidjo, APN
Marcus Mutidjo, APN is a Family Nurse Practitioner in Peoria, IL, registered under NPI 1063825446.
Getting there
The practice address on file is 1701 W GARDEN ST, Peoria, IL 61605. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 209016806 | IL | Family Nurse Practitioner primary |
This provider holds licence 209016806 issued in IL. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Order And Referring Only - Nurse Practitioner
- PAC ID
- 4385988310
- Enrollment ID
- I20181203001767
Medicare enrolment is recorded as approved under the provider type Order And Referring Only - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Family covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LF0000X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1063825446 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 3, 2014 |
| Last updated | Jan 14, 2019 |
| Status | Active |
| Sole proprietor | No |
| Credential | APN |
| Practice address |
1701 W GARDEN ST Peoria, IL 61605 (309) 680-7600 Fax (309) 680-7686 |
| Mailing address |
2214 N UNIVERSITY ST Peoria, IL 61604 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 6 | 3 | 8 | 2 | 5 | 4 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 3 | 3 | 7 | 2 | 1 | 4 | 8 |
Sum = 54 · next multiple of 10 = 60 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.