IndividualActive
Brent Johnson, M.D.
NPI 1003817792 · Sports Medicine (Orthopaedic Surgery) Physician · Peoria, IL
Provider details
- NPI number
- 1003817792
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 036108422 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
6000 N Allen Road
Peoria, IL 61614-3294
Phone: (309) 691-1400
Approximate (ZIP-level) locationGet directions
Mailing address
6000 N Allen Road
Peoria, IL 61614-3294
Registry dates
- Enumerated
- 2005-08-03
- Last updated
- 2025-06-18
- Certified
- 2025-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.