PEORIA EAR NOSE AND THROAT GROUP SC
NPI 1952380628
Otolaryngology in Peoria, IL

Q: What is Peoria Ear Nose And Throat Group Sc's NPI number?

The NPI number for Peoria Ear Nose And Throat Group Sc is 1952380628. It was assigned to this organization in the NPPES registry on January 11, 2006.

Q: What is Peoria Ear Nose And Throat Group Sc's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Active since January 11, 2006

7301 N KNOXVILLE AVE, PEORIA, IL 61614(309) 589-5900(309) 689-0312 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2023, Aug 22, 2020 (2 updates tracked since 2020).

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About Peoria Ear Nose And Throat Group Sc NPPES

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

PEORIA EAR NOSE AND THROAT GROUP SC (NPI 1952380628) is a healthcare organization registered as an otolaryngology in Peoria, Illinois and active in the NPI registry since January 2006. The organization lists Tyler Robertson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1952380628

Entity TypeOrganization

Primary Taxonomy207Y00000X

Legal Business NamePEORIA EAR NOSE AND THROAT GROUP SC

Location Address7301 N KNOXVILLE AVEPeoria, IL 61614-2017

Mailing Address7301 N Knoxville AvePeoria, IL 61614-2017 · (309) 589-5900 · Fax (309) 683-4120

Phone(309) 589-5900

Fax(309) 689-0312

Organization SubpartNo

Authorized OfficialTyler RobertsonCeo · (309) 202-0462

Enumeration DateJanuary 11, 2006

Last NPPES UpdateJuly 22, 20252 updates tracked since enumeration

NPPES CertifiedJuly 22, 2025

✔ NPI 1952380628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in IL · 042000742

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

7301 N KNOXVILLE AVE, Peoria, IL 61614

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 19

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

MRS. HOLLY J DEMICHELIS MA

Audiologist-Hearing Aid Fitter