BRAD ROBERTS DO NPI 1982627204

Family Medicine (Sports Medicine) in Peoria, IL

About BRAD ROBERTS

Brad Roberts is a provider in Peoria, IL with more than 16 years of experience. The NPI number assigned to this provider is 1982627204. The practitioner's primary taxonomy code is Family Medicine (207QS0010X). The provider is registered as an individual and their NPI record was last updated 6 years ago. Brad Roberts is registered with Medicare and accepts claims assignment.

NPI1982627204 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 Name BRAD ROBERTS DO
Provider Location Address6000 N ALLEN RD 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 Address6000 N ALLEN RD 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).
Medical School NameMID WEST MEDICAL COLLEGE
Graduation Year2002
Is Sole Proprietor?No
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 Date07-26-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date06-30-2011 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

BRAD ROBERTS DO
6000 N ALLEN RD
PEORIA, IL
ZIP 61614
Phone: (309) 691-1400
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Mailing Address

BRAD ROBERTS DO
6000 N ALLEN RD
PEORIA, IL
ZIP 61614
Phone: (309) 691-1400

Primary Taxonomy

Taxonomy Code207QS0010X 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
SpecializationSports Medicine
License No.036-116506
License StateIL
Taxonomy DescriptionA family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0361165061MEDICAID (05)IL
1291050001MEDICARE NSC (07)IL
55252002MEDICARE PIN (08)IL

Map Location


BRAD ROBERTS DO address is 6000 N ALLEN RD PEORIA, IL 61614

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023443157 CHRISTINA R AGEE
Individual
Physical Therapist6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1154672822 AARON M MCLEAN PA
Individual
Physician Assistant (Medical)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1184927709 MARK D LAUFFER PA
Individual
Physician Assistant (Surgical Technologist)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1235273574 ALESIA SVYMBERSKY PA-C
Individual
Physician Assistant (Surgical Technologist)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1295867190 MICHAEL GEHRINGER ATC
Individual
Specialist/Technologist (Athletic Trainer)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1356509780 MAUREEN E BRIDGE P.T.A.
Individual
Physical Therapy Assistant6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1407084635DR. LUKE MICHAEL LUETKEMEYER M.D.
Individual
Orthopaedic Surgery6000 N ALLEN RD
PEORIA, IL 61614
(309) 258-3174
1467526699 DEANNA STEIN
Individual
Physical Therapist6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1518245083 KERI LYNN CURRIER ATC
Individual
Specialist/Technologist (Athletic Trainer)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1609041953DR. CHUKWUNENYE KAMALU OSUJI M.D.
Individual
Orthopaedic Surgery6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1629067608DR. ROBBYE O BELL MD
Individual
Pain Medicine (Pain Medicine)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1639319536 BRANDON R GALE PA
Individual
Physician Assistant6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1659560571MR. ERIC A. BUNTING PA-C
Individual
Physician Assistant (Medical)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1710914064DR. DANIEL SCOTT MULCONREY MD
Individual
Specialist6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1780984021 EVAN C FLEMING PA
Individual
Physician Assistant (Surgical Technologist)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1801296520 ALYSE B CLARK PT
Individual
Physical Therapist6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1841245867MR. MARK O FABISH PHYSICAL THERAPIST
Individual
Physical Therapist6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1841314556DR. PATRICK T O'LEARY MD
Individual
Orthopaedic Surgery6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1932214251 MOLLY DIANE BLACK MD
Individual
Orthopaedic Surgery6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400
1992125843 KATHERINE GAVIN ATC
Individual
Specialist/Technologist (Athletic Trainer)6000 N ALLEN RD
PEORIA, IL 61614
(309) 691-1400