Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Peoria Ear Nose and Throat Group SC

Organization Otolaryngology Physician · NPI 1952380628

Peoria Ear Nose and Throat Group SC is an Otolaryngology Physician in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006

Practice location Address checks out

7301 N Knoxville Ave
Peoria, IL 61614-2017
Phone: (309) 589-5900
Fax: (309) 689-0312
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 042000742 (IL)

Record details

NPI number1952380628
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tyler Robertson — Ceo · (309) 202-0462
NPI enumeratedJanuary 11, 2006
Last updated in NPPESJuly 22, 2025
Certification dateJuly 22, 2025
Mailing address7301 N Knoxville Ave, Peoria, IL 61614-2017

Other providers in Peoria