IndividualActive
Brandon Bockewitz, MD
NPI 1619199627 · Sports Medicine (Family Medicine) Physician · Peoria, IL
Provider details
- NPI number
- 1619199627
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036121479 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
5401 N Knoxville Ave Ste 112
Peoria, IL 61614-5021
Phone: (309) 693-2020
Fax: (309) 683-8850
Approximate (ZIP-level) locationGet directions
Mailing address
5100 Reliable Pkwy
Chicago, IL 60686-0001
Registry dates
- Enumerated
- 2007-05-02
- Last updated
- 2020-01-07
- Certified
- 2020-01-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.