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Dr. Brent C Johnson, MD
Specialist in Peoria, Illinois
NPI 1003817792

Brent C Johnson is a Specialist based in Peoria, IL. Brent C Johnson practices in Peoria, IL and has the professional credentials of MD. The NPI Number for Brent C Johnson is 1003817792 and holds a License No. 036108422 (Illinois).

The current practice location address for Brent C Johnson is 6000 N Allen Road, Peoria, IL and can be reached out via phone at 309-691-1400. You can also correspond with Brent C Johnson through the mailing address at 6000 N ALLEN ROAD, PEORIA, IL - 61614-3294 (mailing address contact number: 309-691-1400).

Location: 6000 N Allen Road, Peoria, IL, 61614-3294
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003817792
Provider Name
Brent C Johnson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6000 N Allen Road, Peoria, IL, 61614-3294
Phone Number
309-691-1400
Fax Number
Provider Enumeration Date
08/03/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036108422 05 IL
institution
Provider Business Practice Location Address Details
Address
6000 N Allen Road
City
Peoria
State
Illinois
Zip
61614-3294
Phone Number
309-691-1400
Fax Number
person
Provider Business Mailing Address Details
Address
6000 N Allen Road
City
Peoria
State
Illinois
Zip
61614-3294
Phone Number
309-691-1400
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
036108422 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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