Individual provider · Type 1 NPI

Mary Margaret Keenan

Gerontology Nurse Practitioner · Peoria, IL

NPI number 1124988944 Active

Practice location

200 E Pennsylvania Ave
Peoria, IL 61603-3089

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X209035156 (IL)
Neuroscience Registered Nurse 163WN0800X41513787 (IL)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1124988944

Mary Margaret Keenan's National Provider Identifier is 1124988944, issued on Nov 14, 2025. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Peoria, IL. The record was last updated on Apr 10, 2026.