Active NPI
Blesilda Borero, P.T.
- Physical Therapist
- Peoria, IL
National Provider Identifier
1487065967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070 016164
- Practice address
- 2322 W Willow Knolls Dr
Peoria, IL 61614-1307 - Phone
- (309) 589-0888
- NPI assigned
- May 18, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070 016164 | IL | Primary |
Addresses
Primary practice location
2322 W Willow Knolls Dr
Peoria, IL 61614-1307
Mailing address
5250 N Knoxville Ave
Apt. 313
Peoria, IL 61614-5050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070 016164 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Bound Healthcare, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Sycamore, IL
- NPI 1952553133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400371200000",
"number": "1487065967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5250 N KNOXVILLE AVE",
"address_2": "APT. 313",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2322 W WILLOW KNOLLS DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616141307",
"telephone_number": "309-589-0888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORERO",
"first_name": "BLESILDA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-18",
"last_updated": "2014-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070 016164",
"primary": true
}
],
"identifiers": [],
"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 May 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.