Healthcare Provider Details

I. General information

NPI: 1790294403
Provider Name (Legal Business Name): SARAH KNEIP APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MAGANA APN

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E PENNSYLVANIA AVE
PEORIA IL
61603-3089
US

IV. Provider business mailing address

200 E PENNSYLVANIA AVE
PEORIA IL
61603-3089
US

V. Phone/Fax

Practice location:
  • Phone: 309-624-4000
  • Fax: 309-308-0221
Mailing address:
  • Phone: 309-624-4000
  • Fax: 309-308-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209016667
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: