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MR. TOMMY BOHANNAN
NPI 1407213796
Durable Medical Equipment & Medical Supplies in Dunlap, IL

Active since January 19, 2016
11417 N BOULDER CREEK CT, DUNLAP, IL 61525(309) 678-8081 Get Directions Write a Review

NPPES record last updated: March 8, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 15, 2016, Jan 19, 2016 (2 updates tracked since 2016).

About Mr. Tommy Bohannan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TOMMY BOHANNAN (NPI 1407213796) is an individual durable medical equipment & medical supplies provider in Dunlap, Illinois and active in the NPI registry since January 2016.

NPPES Registry Identity

NPI1407213796
Entity TypeIndividualMale
Primary Taxonomy332B00000X
Provider Legal NameMR. TOMMY BOHANNAN
Location Address11417 N BOULDER CREEK CTDunlap, IL 61525-1500
Mailing Address11417 N Boulder Creek CtDunlap, IL 61525-1500 · (309) 678-8081
Phone(309) 678-8081
Sole ProprietorYes
Enumeration DateJanuary 19, 2016
Last NPPES UpdateMarch 8, 20162 updates tracked since enumeration
✔ NPI 1407213796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
11417 N BOULDER CREEK CT, Dunlap, IL 61525
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BOHANNAN MEDICAL DIST., LLC
Durable Medical Equipment & Medical Supplies
11417 N BOULDER CREEK CT
DUNLAP, IL 61525
Peoria County (309) 678-8081

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tommy Bohannan's NPI number?

The NPI number for Tommy Bohannan is 1407213796. It was assigned to this individual provider in the NPPES registry on January 19, 2016.

Where is Tommy Bohannan located?

Tommy Bohannan practices at 11417 N Boulder Creek Ct, Dunlap, IL 61525. The listed phone number is (309) 678-8081.

What is Tommy Bohannan's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Tommy Bohannan was last updated on March 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.