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Geralyn Sue Prullage , APN

Nurse Practitioner - Neonatal β€’ Springfield, IL

Active NPI 1164723656 Individual Practitioner Female Practitioner
Practice location in NPPES

415 N 9th St Ste 4w16
Springfield, IL 627025303

Call 2175458000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

415 N 9th St Ste 4w16

Springfield, IL 627025303

Telephone 2175458000
Organization at the Same NPPES Address or Phone
Siu Physicians & Surgeons, Inc Facility NPI 1164055976

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Alton, IL; Breese, IL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2010

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Springfield and Illinois

12 active clinicians are listed under Nurse Practitioner - Neonatal with a practice address in Springfield, IL (118 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Springfield

0% of these 12 clinicians have the CMS telehealth indicator.

0% of these 12 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-12-28
Nurse Practitioner - Neonatal Primary Specialty

NUCC Taxonomy Code: 363LN0000X

License # reported to NPPES IL 209008472
Nurse Practitioner - Neonatal, Critical Care

NUCC Taxonomy Code: 363LN0005X

License # reported to NPPES IL 041207587
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Secondary Practice Locations

2910 Gilbert Ln

Alton, IL 620025504

Phone: 6183632707

9515 Holy Cross Ln

Breese, IL 622303618

Phone: 6185264511

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

28 listed
Dr. Janet Albers , MD

Family Medicine

NPI 1023006913

Doctor of Medicine (M.D.)

Jay Benoit

Nurse Practitioner - Family

NPI 1003579335
Dr. Mukul Bhattarai , MD

Internal Medicine - Cardiovascular Disease

NPI 1013204262

Doctor of Medicine (M.D.)

Dr. Fadel Bofarrag , MD, MPH

Internal Medicine - Cardiovascular Disease

NPI 1003291279

Doctor of Medicine (M.D.), Master of Public Health

Dr. Basar Cenik , MD

Psychiatry & Neurology - Psychiatry

NPI 1013350446

Doctor of Medicine (M.D.)

Olivia Delay , FNP-C

Nurse Practitioner - Family

NPI 1033795992

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 28, 2021

Nurse Practitioner (license number reported to NPPES: IL 041207587)

πŸ“
Updated Practice Location July 21, 2021

Registered at 415 N 9TH ST STE 4W16, SPRINGFIELD, IL 627025303 (Tel: 2175458000)

πŸ“
Updated Business Mailing Address July 21, 2021

Registered at 201 E MADISON ST STE 328, SPRINGFIELD, IL 627025131 (Tel: 2175458000)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2021

Nurse Practitioner (license number reported to NPPES: IL 209008472)

βœ…
NPI Profile Active November 15, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) November 15, 2010

Registered at 2910 GILBERT LN, ALTON, IL 620025504 (Tel: 6183632707)

πŸ“
Business Mailing Address (Initial Record) November 15, 2010

Registered at 2910 GILBERT LN, ALTON, IL 620025504 (Tel: 6183632707)

πŸ‘€
Provider Name / Credentials (Initial Record) November 15, 2010

Recorded as GERALYN PRULLAGE, APN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2010

Nurse Practitioner (license number reported to NPPES: IL 041207587)

🟒
Initial NPI Registration & Enumeration November 15, 2010

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1164723656
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 15, 2010
Last Update: December 28, 2021
Sole Proprietor: Yes

Mailing Address

201 E Madison St Ste 328

Springfield, IL 627025131

Phone: 2175458000

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.