Active NPI
Brian Sutter
- Counselor
- West Peoria, IL
National Provider Identifier
1174701726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 225607
- Practice address
- 3000 W Rohmann Ave
West Peoria, IL 61604-4842 - Phone
- (309) 671-0300
- NPI assigned
- Feb 6, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 225607 | IL | Primary |
Addresses
Primary practice location
3000 W Rohmann Ave
West Peoria, IL 61604-4842
Mailing address
3000 W Rohmann Ave
West Peoria, IL 61604-4842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 24, 2024 through May 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225607 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202256000000",
"number": "1174701726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 W ROHMANN AVE",
"city": "WEST PEORIA",
"state": "IL",
"postal_code": "616044842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 W ROHMANN AVE",
"city": "WEST PEORIA",
"state": "IL",
"postal_code": "616044842",
"telephone_number": "309-671-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTER",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-06",
"last_updated": "2008-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "225607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.