NPI 1003817792

Brent C Johnson, MD

Practitioner Sports Medicine (Orthopaedic Surgery) Physician Peoria, IL

Practice location

Address: 6000 N Allen Road, Peoria, IL 61614-3294
Phone: (309) 691-1400

Registered specialties (2)

Sports Medicine (Orthopaedic Surgery) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207XX0005X Licence 036108422 (IL)

Other Orthopaedic Surgery providers in Illinois →

Orthopaedic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207X00000X Licence 036108422 (IL)

Registry record

NPI: 1003817792
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Aug 2005
Record last updated: 18 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.