Bradley Bock, APRN, FNP-BC, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Chillicothe, IL
NPI 1023779402 · NPPES record last updated Mar 4, 2022
Key facts
- NPI
- 1023779402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209024642 (IL)
- Practice address
- 311 N 4TH St
Chillicothe, IL 61523-2059 - Phone
- (309) 274-4336
- Fax
- (309) 274-3120
- NPI assigned
- Jan 6, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
- Osf Saint Clare Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220311002210 | IL | Practitioner - Nurse Practitioner | 3678968534 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.024642 | IL | MD | Family Medicine Physician |
| 209024642 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients |
Locations
319 N 4th St
Chillicothe, IL 61523
Phone (309) 274-4336
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
2806 N Knoxville Ave
Peoria, IL 61604
Phone (309) 655-6961
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 209.024642 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209024642 | IL | Yes |
Addresses
Primary practice location
311 N 4TH St
Chillicothe, IL 61523-2059
Mailing address
311 N 4TH St
Chillicothe, IL 61523-2059
Phone (309) 274-4336
Other providers in Chillicothe, IL
- Ambulance Rescue 33 LTD.
- Denise A Amundson
- Deirdre Andrejasich
- Arc at Chillicothe LLC
- Arc at Chillicothe LLC
- Chad Asa Bohannon
- Vanessa K Bohm
- Rachel B Bridgewater
- Joy Lynn Briggs
- Bulldog Alliance Inc.
All providers in Chillicothe, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.