Mary Tisdale
CNM | Nurse Practitioner | 17+ years Exp
1001 Main St Ste 300, Peoria
Illinois, 61606-2036
309-495-0200
Mary Tisdale is a Peoria, Illinois based nurse practitioner with 17 years of experience in . She completed her graduation in 2009. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mary Tisdale is 209007925 for Nurse Practitioner in Illinois. Her current practice location is 1001 Main St Ste 300, Peoria. Patients can reach her at 309-495-0200 or can fax her at 309-676-6545. Mary Tisdale is CNM and her NPI number (Unique professional ID assigned by NPPES) is 1992034532.
Mary Tisdale has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Mary Tisdale speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mary Tisdale |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | CNM |
| Experience: | 17+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2009 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1001 Main St Ste 300, Peoria,
Illinois, 61606-2036 |
| Phone: | 309-495-0200 |
| Fax: | 309-676-6545 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 7810164738 |
| Enrollment ID: | I20120118000197 |
| NPI Number: | 1992034532 |
| NPI Enumeration Date: | 10 Dec, 2009 |
| NPI Last Update On: | 05 Apr, 2021 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mary Tisdale are as mentioned below.
| License Number | Specialization | State | Status | |
| 209007925 | Nurse Practitioner | Illinois | Primary | |
| 209008217 | Nurse Practitioner | Illinois | Secondary | |
| APRN11000699 | Advanced Practice Midwife | Florida | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Mary Tisdale is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Springfield Clinic Llp (0547166076) | 659 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mary Tisdale such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 9337001 | Medicaid | Illinois | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mary Tisdale
1025 S 6th St,
Springfield, Illinois |
| Zip: | 62703-2403 |
| Phone Number: | 217-528-7541 |
| Fax Number: | 772-879-0436 |
Patients can reach Mary Tisdale at
1001 Main St Ste 300, Peoria, Illinois or can
call to book an appointment on 309-495-0200.
Comments/ Reviews:
Patients can read all the reviews posted for Mary Tisdale below. You may also share your own experience like the quality of treatment, behavior, and overall care provided by Mary Tisdale. It will help others make informed decisions.
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.