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

Kimani Fitzgerald

Individual provider Family Nurse Practitioner · NPI 1740011154

Kimani Fitzgerald is a Nurse Practitioner in East Peoria, Illinois. Qualified in 2022, 4 years ago. Practices with Proctor Health Systems, a 132-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2024
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Practice location Address checks out

1000 Centennial Dr
East Peoria, IL 61611-4916
Phone: (309) 324-0880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209.029516 (IL)

Record details

NPI number1740011154
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 8, 2024
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Proctor Health Systems — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations14 on file with Medicare

Other providers in East Peoria