Individual provider Active NPI

Mikala Rae Brinkman, BA, MD

  • Diagnostic Radiology Physician
  • Peoria, IL
National Provider Identifier
1366651192
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-118496 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-7768
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-118496 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823001125 IL Practitioner - Diagnostic Radiology 9638226343 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians
Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-1400

111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522

2351 N Broad St
Galesburg, IL 61401-1456
Phone (906) 786-5707

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-2428

5200 Reliable Pkwy
Chicago, IL 60686-0052

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272

530 Neglen Oak Ave
Peoria, IL 61636-0001
Phone (309) 655-2000

530 Park Ave E
Perry Memorial Hosp
Princeton, IL 61356-3901
Phone (815) 875-2811

6700 W 95TH St
Oak Lawn, IL 60453-2106
Phone (708) 974-7600

707 N Logan Ave
Danville, IL 61832-4360
Phone (309) 740-4272

812 N Logan Ave
Danville, IL 61832-3752
Phone (217) 443-5000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-118496ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 20, 2025 Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
Cira Michigan PC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients

Locations

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1366651192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKMAN",
        "first_name": "MIKALA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "BA, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-118496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.