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

Dr. Kody Duane Dormire, DO

Individual provider Pediatrics Physician · NPI 1083241293

Dr. Kody Duane Dormire, DO is a Pediatric Medicine in Peoria, Illinois. Graduated from Oklahoma State University College of Osteopathic Medicine in 2020, 6 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
6
Trained at
Oklahoma State University College of Osteopathic Medicine
Licensed in
IL
In the registry since
2020
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-4940
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036162380 (IL)
Pediatrics Physician Taxonomy 208000000X · Licence 036162380 (IL)

Record details

NPI number1083241293
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 26, 2020
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024
Mailing address400 E Cedar St, Perry, OK 73077-7833

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Also practisesINTERNAL MEDICINE
Medical schoolOKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2020 (6 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Peoria