DR. MARK R PHILLIPS


Address: 303 N William Kumpf Blvd, Peoria, IL 61605-2507
Phone: 3096765546

DR. MARK R PHILLIPS (NPI# 1366441644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366441644
Entity Type Individual
Full Name DR. MARK R PHILLIPS
Credential MD
Practice Address 303 N William Kumpf Blvd
Peoria
IL 61605-2507
Practice Telephone 3096765546
Practice Fax Number 3096765045
Mailing Telephone 3096765546
Mailing Fax Number 3096765045
Enumeration Date 2005-07-19
Last Update Date 2009-12-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
36067854 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 36067854 05

Other Providers MARK PHILLIPS

NPI Name Taxonomy Address Enumeration
1033697073 Mark Phillips Naturopath 1170 N Gilbert Rd Ste 15, Gilbert, AZ 85234-2340 2018-08-01
1639699663 Mark W. Phillips Nurse Practitioner 1 S School Ave Ste 200, Sarasota, FL 34237 2017-06-21
1225589328 Mark Phillips Counselor 200 Century Park S Ste 116, Birmingham, AL 35226-3923 2016-10-24
1619293735 Mark A Phillips Social Worker 65 Technology Way Ste 1e3, Nashua, NH 03060 2010-04-14
1245403211 Mark Terrance Phillips Dentist 4024 8th Ln, Anoka, MN 55303-1251 2008-04-10
1275568735 Mark C Phillips Legal Medicine 860 N Myrtle Rd, Myrtle Creek, OR 97457-9626 2006-07-12
1598704256 Mark D. Phillips Dentist 311 N Breiel Blvd, Middletown, OH 45042-3868 2006-06-06
1548212863 Mark J Phillips Family Medicine 3627 Webber St, Suite A, Sarasota, FL 34232-4412 2006-05-16
1558336297 Mark Lynn Phillips Specialist 1 Raider Circle, Northbrook High School, Houston, TX 77080 2006-02-17
1275511966 Mark Lucas Phillips Pain Medicine 522 N Elam Ave, Ste 203, Greensboro, NC 27403-1151 2006-01-04

Office Location

Street Address 303 N WILLIAM KUMPF BLVD
City PEORIA
State IL
Zip Code 61605-2507

Providers in the same location

NPI Name Taxonomy Address Enumeration
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
1043552227 Keith Thomas Corpus Orthopaedic Surgery 303 N William Kumpf Blvd, Peoria, IL 61605 2013-03-26
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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043552227 Keith Thomas Corpus Orthopaedic Surgery 303 N William Kumpf Blvd, Peoria, IL 61605 2013-03-26
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

Providers in the same taxonomy and state

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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Competitor

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City PEORIA
Zip Code 61605

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Dataset Information

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.

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