DR. KEITH THOMAS CORPUS (NPI# 1043552227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043552227 |
| Entity Type | Individual |
| Full Name | DR. KEITH THOMAS CORPUS |
| Credential | MD |
| Practice Address |
303 N William Kumpf Blvd Peoria IL 61605 |
| Mailing Address |
303 N William Kumpf Blvd Peoria IL 61605-2507 |
| Practice Telephone | 3096765546 |
| Mailing Telephone | 3096765546 |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2019-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
036.148410 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 303 N William Kumpf Blvd, Peoria, IL 61605 | 3096765546 | |
| 7800 N Sommer St Ste 608, Peoria, IL 616151968 | 3096765546 |
| Street Address |
303 N WILLIAM KUMPF BLVD |
| City | PEORIA |
| State | IL |
| Zip Code | 61605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366441644 | Mark R Phillips | Orthopaedic Surgery | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2005-07-19 |
| 1285137653 | Valerie T Kale | Physician Assistant | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2018-03-13 |
| 1114475597 | Lindsey A. Johnston | Nurse Practitioner | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2016-09-14 |
| 1871945667 | Eric L. Pfeiffer | Nurse Practitioner | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2016-07-06 |
| 1588056881 | Jonathan Isaac Hochstetler | Specialist/Technologist | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2015-02-23 |
| 1912251653 | Adam Kyle Jelinek | Physician Assistant | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2012-11-02 |
| 1578870440 | Keirstin A Mott | Physician Assistant | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2010-09-13 |
| 1811220650 | Musculoskeletal Surgery Center, LLC | Clinic/Center | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2009-09-11 |
| 1689817371 | Maryelizabeth Tyler Rashid | Specialist | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2009-04-11 |
| 1558501106 | Brian Staniszewski | Physical Therapist | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2009-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386131878 | Nicholas Anthony Helling | Physical Therapist | 518 W Romero B Garret Ave, Poeria, IL 61605 | 2018-04-19 |
| 1891241022 | Peoria Slf Lp | Assisted Living Facility | 518 West Romeo B. Garrett Avenue, Peoria, IL 61605 | 2016-08-28 |
| 1932479664 | Michelle L Whitelow | Nurse Practitioner | 711 W John Gwynn Jr. Avenue, Peoria, IL 61605 | 2012-01-11 |
| 1982852877 | Jason M Anane-sefah | Orthopaedic Surgery | 303 North Kumpf Boulevard, Peoria, IL 61605 | 2008-09-04 |
| 1902098908 | Calvary Elderly Home Help Program | Home Health | 1709 W Lincoln Ave, Peoria, IL 61605 | 2007-08-14 |
| 1023104437 | Thomas Anderson | Optometrist | 710 W Third Avenue, Peoria, IL 61605 | 2006-10-04 |
| 1841382298 | Devashish Agarwal | Family Medicine | 1701 W. Garden Street, Peoria, IL 61605 | 2006-09-29 |
| 1497763197 | Larry T Rolle | Pharmacist | 411 Martin Luther King Dr., Peoria, IL 61605 | 2006-08-04 |
| 1568404762 | Joseph P Kelly Iv | Physical Therapist | 303 N. Kumpf Blvd, Peoria, IL 61605 | 2006-06-12 |
| 1003861634 | Patrick William Elwood | Neurological Surgery | 719 N William Kumpf Blvd, Suite 100, Peoria, IL 61605 | 2006-05-23 |
| Find all providers in zip 61605 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366441644 | Mark R Phillips | Orthopaedic Surgery | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2005-07-19 |
| 1841290913 | Stephen R Orlevitch | Orthopaedic Surgery | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2005-07-29 |
| 1649270711 | Steven K Below | Orthopaedic Surgery | 303 N William Kumpf Blvd, Peoria, IL 61605-2507 | 2005-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048395 | Dr Ouilife LLC | Orthopaedic Surgery | 640 S Federal St Apt 410, Chicago, IL 60605-1800 | 2020-03-18 |
| 1316437890 | Darcy L Marr | Orthopaedic Surgery | 3030 Salt Creek Lane, Suite 100, Arlington Heights, IL 60005 | 2018-05-10 |
| 1568851251 | Benjamin Scott Kester | Orthopaedic Surgery | 1725 W Harrison St Ste Rush, Chicago, IL 60612-3841 | 2015-01-18 |
| 1609041565 | Sheryl Lynn Lipnick | Orthopaedic Surgery | 1585 N. Barrington Rd Ste 101, Drs. Bldg. 2, Hoffman Estates, IL 60169-5019 | 2008-04-22 |
| 1295937555 | Gregory Lamar Primus | Orthopaedic Surgery | 7543 183rd St, Tinley Park, IL 60477-6208 | 2007-05-31 |
| 1154454635 | Benjamin Domb | Orthopaedic Surgery | 999 E Touhy Ave Ste 450, Des Plaines, IL 60018-2748 | 2007-03-13 |
| 1518981612 | Sean Daniel Odell | Orthopaedic Surgery | 375 S Roselle Rd, Schaumburg, IL 60193-5544 | 2006-07-26 |
| 1568419463 | Mark K. Bowen | Orthopaedic Surgery | 680 N Lake Shore Dr Ste 924, Chicago, IL 60611 | 2006-05-27 |
| 1639146103 | Jean Benoit Houle | Orthopaedic Surgery | 4121 Veterans Memorial Dr, Mount Vernon, IL 62864-6262 | 2006-03-03 |
| 1093792277 | Scott Eric Urch | Orthopaedic Surgery | 503 E Grant St, Macomb, IL 61455-3313 | 2005-12-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.