Mary Keenan
Mary Keenan is a Gerontology Nurse Practitioner in Peoria, IL, registered under NPI 1124988944. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 200 E PENNSYLVANIA AVE, Peoria, IL 61603. 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 |
|---|---|---|
| 209035156 | IL | Gerontology Nurse Practitioner primary |
| 41513787 | IL | Neuroscience Registered Nurse |
This provider holds licence 209035156 issued in IL. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Gerontology covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LG0600X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363LG0600X | Gerontology Nurse Practitioner Gerontology | 209035156 | IL | primary |
| 163WN0800X | Neuroscience Registered Nurse Neuroscience | 41513787 | IL |
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 | 1124988944 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Nov 14, 2025 |
| Last updated | Apr 10, 2026 |
| Status | Active |
| Sole proprietor | No |
| Practice address |
200 E PENNSYLVANIA AVE Peoria, IL 61603 (309) 624-4000 |
| Mailing address |
530 NE GLEN OAK AVE Peoria, IL 61637 |
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 | 1 | 2 | 4 | 9 | 8 | 8 | 9 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 4 | 4 | 9 | 8 | 7 | 9 | 8 |
Sum = 76 · next multiple of 10 = 80 · check digit = 4 · actual last digit = 4
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.