DR. COLIN NEIL BOMSTAD MD
NPI 1407640097
Student in an Organized Health Care Education/Training Program in Peoria, IL

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 08, 2025

530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Dr. Colin Neil Bomstad Md NPPES

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

DR. COLIN NEIL BOMSTAD MD (NPI 1407640097) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1407640097

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. COLIN NEIL BOMSTADCredential: MD

Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001

Mailing Address4459 E 1369th RdEarlville, IL 60518-6265 · (815) 993-8702

Phone(309) 655-2000

Sole ProprietorYes

Enumeration DateApril 8, 2025

NPPES CertifiedMarch 30, 2025

✔ NPI 1407640097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

530 NE GLEN OAK AVE, Peoria, IL 61637

Open in Google Maps ↗