Healthcare Provider Details

I. General information

NPI: 1619820354
Provider Name (Legal Business Name): ARIEL ELIZABETH PRIBBLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT JESSE RD STE 250
NORMAL IL
61761-6290
US

IV. Provider business mailing address

5 LAKE BLUFF CT
BLOOMINGTON IL
61704-7255
US

V. Phone/Fax

Practice location:
  • Phone: 309-888-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.036012
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: