Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelsey Marie Thacker

Individual provider Nurse Practitioner · NPI 1245765296

Kelsey Marie Thacker is a Nurse Practitioner in Mt Zion, Illinois. Qualified in 2016, 10 years ago. Practices with Decatur Orthopedic Center LLC, a 9-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2017

Practice location Address checks out

104 E Ashland Ave
Mt Zion, IL 62549-1271
Phone: (217) 864-2665
Fax: (217) 864-8042
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209015926 (IL)

Record details

NPI number1245765296
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 27, 2017
Last updated in NPPESApril 27, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Decatur Orthopedic Center Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mt Zion