NPIMap

Organization Active NPI

Tri County Radiology

  • Vascular & Interventional Radiology Physician
  • Peoria, IL
National Provider Identifier
1346228848
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
TRI COUNTY RADIOLOGY
Practice address
5409 N Knoxville Ave
Peoria, IL 61615
Phone
(309) 682-7750
Fax
(309) 682-7786
NPI assigned
Jan 4, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. W Robert Cooper
Title
Cmpe, CHBC
Phone
(309) 682-7750

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X NU
Nuclear Radiology Physician 2085N0904X NU
Vascular & Interventional Radiology Physician 2085R0204X NU Primary
Diagnostic Ultrasound Physician 2085U0001X NU

Addresses

Primary practice location

5409 N Knoxville Ave
Peoria, IL 61615

Mailing address

PO Box 3853
Peoria, IL 61612-3853
Phone (800) 899-5757

Other identifiers 2

IdentifierTypeStateIssuer
IL0100OtherILJOHN DEERE
0007222342OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1346228848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3853",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616123853",
            "telephone_number": "800-899-5757",
            "fax_number": "314-821-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-682-7750",
            "fax_number": "309-682-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CMPE, CHBC",
        "authorized_official_telephone_number": "309-682-7750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0007222342",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.