COMPREHENSIVE ORTHOPEDICS P. C. NPI 1902040124

NPI Information

  • NPI: 1902040124
  • Provider Name: COMPREHENSIVE ORTHOPEDICS, P. C.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 5401 NORTH KNOXVILLE AVE
    SUITE 400
    PEORIA, IL
    ZIP 61614
  • Phone: (309) 692-6644

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NPI Details

COMPREHENSIVE ORTHOPEDICS, P. C. is a specialist in Peoria, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. COMPREHENSIVE ORTHOPEDICS, P. C. NPI is 1902040124. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5401 NORTH KNOXVILLE AVE
SUITE 400
PEORIA, IL
ZIP 61614-021
Phone: (309) 692-6644
Fax: (309) 692-8992

The provider's authorized official is George W. Lane .
The authorized official title is President and has the following contact phone number (309) 692-6644.

The enumeration date for this NPI number is 5/1/2009 and was last updated on 3/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist060007948ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1060007948MEDICAIDILLINOIS
2060007948OTHERILLINOISSTATE LICENSE
3368270100OTHERILLINOISOWCP DEPARTMENT OF LABORR
47230175OTHERILLINOISBLUE CROSS BLUE SHIELD
5CH8612OTHERILLINOISRR MEDICARE
6707840MEDICARE PINILLINOIS
7050053OTHERILLINOISHEALTH ALLIANCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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