Johnson, Brent C

Johnson, Brent C is an individual health care provider with primary practice located at 6000 N Allen Road , Peoria IL 61614-3294. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Johnson, Brent C can be contacted via phone (309) 691-1400.

Contact Information

Primary practice address
6000 N Allen Road Peoria IL 61614-3294
Phone: (309) 691-1400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036108422 Illinois
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 036108422 Illinois

Profile Details

NPI number 1003817792
LBN Legal business name Johnson, Brent C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Jun 18th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003817792 NPPES
Illinois MEDICAID 036108422

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