Individual provider Active NPI

Skye BF Ortman

  • Dental Hygienist
  • East Peoria, IL
National Provider Identifier
1578435459
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020.016633 Issued in IL
Practice address
252 E Washington St
East Peoria, IL 61611-2561
Phone
(309) 360-1813
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 020.016633 IL Primary

Addresses

Primary practice location

252 E Washington St
East Peoria, IL 61611-2561

Mailing address

5703 W Cassidy Dr
Peoria, IL 61607-9369
Phone (309) 360-1813

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

LicenseStateTypeSpecialty
020.016633ILMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1578435459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5703 W CASSIDY DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616079369",
            "telephone_number": "309-360-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112561",
            "telephone_number": "309-360-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTMAN",
        "first_name": "SKYE",
        "middle_name": "BF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020.016633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.