Roberts, Brad

Roberts, Brad is an individual health care provider with primary practice located at 6000 N Allen Rd , Peoria IL 61614-3294. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Roberts, Brad can be contacted via phone (309) 691-1400.

Contact Information

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

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036-116506 Illinois

Profile Details

NPI number 1982627204
LBN Legal business name Roberts, Brad
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Dec 31st, 2019 - about 7 years ago

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 1982627204 NPPES
Illinois MEDICAID 0361165061

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