Marcus Ismedhi Mutidjo, APN
Family Nurse Practitioner · Peoria, IL
Marcus Ismedhi Mutidjo, APN is a family nurse practitioner with a practice address in Peoria, Illinois, and NPI 1063825446, issued on Jun 3, 2014. Check the license (Illinois 209016806, as entered in NPPES) with the Illinois board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Marcus Ismedhi Mutidjo
- Credential
- APN
- Primary taxonomy
- Family Nurse Practitioner 363LF0000X
- License number
- 209016806 IL
Self-reported in NPPES; status is on the state search - Practice location
- 1701 W Garden St, Peoria, IL 61605
- Phone
- (309) 680-7600
- Enumerated
- Jun 3, 2014
- Record last updated
- Jan 14, 2019 (not updated in 7 years: call before relying on the address or phone)
- Fax
- (309) 680-7686
- Entity
- Type 1 · individual
8 nearest family nurse practitioner records → All 7,639 in Illinois → Look up another NPI →
Also registered at 1701 W Garden St
A shared address usually means a shared clinic or building; it does not show who employs whom.
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- David Gorenz, M.D.Pulmonary Disease Physician1285767087
- Sarah Koscica, MDFamily Medicine Physician1003814625
- Sandra Leman, PA-CPhysician Assistant1790889392
Verify Marcus Ismedhi Mutidjo in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Illinois board licenses this profession
Search for license 209016806Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
97% fewer Medicare Part D claims than the average family nurse practitioner in 2024
43 Medicare Part D claims for 12 beneficiaries, against an average of 1,305 among the 140,557 providers of this specialty who prescribed in Part D.
Most prescribed
- Descovy16 claims
- Emtricitabine-Tenofovir Disop12 claims
Source: CMS Medicare Part D Prescribers by Provider and Drug, 2024 (data.cms.gov). Part D covers prescriptions for Medicare patients only; drugs with fewer than 11 claims are not published.
Marcus Ismedhi Mutidjo among 7,639 family nurse practitioner records in Illinois
Marcus Ismedhi Mutidjo, APN is one of 7,639 family nurse practitioner records with a practice address in Illinois. 78% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2014, is newer than 20% of them.
- NPI issued2014 · 20% of these records are older, 76% newer
- In a Medicare fileYes · 78% of these records are
- In the CMS Doctors and Clinicians fileNo · 63% of these records are
- Record last updated2019 · 39% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363LF0000X and a Illinois practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
215 family nurse practitioner records list a practice address in Peoria
They are 215 of the 4,621 NPPES records with a practice address in Peoria, and 7,639 family nurse practitioner records in Illinois.
All 7,639 in Illinois → Every provider in Peoria → Family Nurse Practitioner nationwide →
The 8 family nurse practitioner records with the nearest ZIP codes
- Julie DeibelPeoria, IL 616051548651490
- Kathryn Endress, NPPeoria, IL 616051487054425
- Tina Saddler, APNPeoria, IL 616051902951957
- Punam Trivede, APNPeoria, IL 616051790258473
- Jami Wallace, APRNPeoria, IL 616051144606195
- Michelle Whitelow, NURSE PRACTITIONERPeoria, IL 616051932479664
- Tiffany Ashby-Funches, APN, FNP-BCPeoria, IL 616041386446110
- Karen Collins, APNPeoria, IL 616061356535645
Common questions
What is Marcus Ismedhi Mutidjo, APN's NPI number?
Marcus Ismedhi Mutidjo, APN's National Provider Identifier (NPI) is 1063825446, issued on Jun 3, 2014. An NPI identifies a provider in billing; it is not a license.
Where is Marcus Ismedhi Mutidjo, APN located?
The NPPES record lists a practice address at 1701 W Garden St, Peoria, IL, 61605. Phone: (309) 680-7600. Providers update this record themselves, so call before visiting.
How can I verify Marcus Ismedhi Mutidjo, APN's license?
NPPES lists Illinois license number 209016806, as entered by the provider. Search the Illinois board that licenses this profession; the NPPES record confirms identity only.
How much does Marcus Ismedhi Mutidjo, APN prescribe under Medicare Part D?
In 2024, Marcus Ismedhi Mutidjo, APN had 43 Medicare Part D claims for 12 beneficiaries; the average among family nurse practitioner prescribers was 1,305. Part D covers Medicare prescriptions only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.