DR. DEAN ROBERT BORDEAUX MD NPI 1770824112

Family Medicine in Peoria, IL

About DEAN BORDEAUX

Dean Bordeaux is a provider in Peoria, IL. The NPI number assigned to this provider is 1770824112. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 5 years ago.

NPI1770824112 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. DEAN ROBERT BORDEAUX MD
Provider Location Address7614 N PATTON LN PEORIA, IL 61614 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address7614 N PATTON LN PEORIA, IL 61614 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date03-11-2013 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date03-11-2013 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. DEAN ROBERT BORDEAUX MD
7614 N PATTON LN
PEORIA, IL
ZIP 61614
Phone: (309) 692-8686
Fax: (309) 692-8741
Get Directions

Mailing Address

DR. DEAN ROBERT BORDEAUX MD
7614 N PATTON LN
PEORIA, IL
ZIP 61614
Phone: (309) 692-8686
Fax: (309) 692-8741

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.036031368
License StateIL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine2743730WINo

Taxonomy Description: family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Map Location


DR. DEAN ROBERT BORDEAUX MD address is 7614 N PATTON LN PEORIA, IL 61614