Individual provider Active NPI

Victoria J Brockhouse, DO

  • Family Medicine Physician
  • Bloomington, IL
National Provider Identifier
1790744555
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
336.043935 Issued in IL
Practice address
702 W Chestnut St
Bloomington, IL 61701-2814
Phone
(309) 567-1400
Fax
(309) 557-1461
NPI assigned
Mar 21, 2006
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 336.043935 IL Primary
Family Medicine Physician 207Q00000X 036081580 IL

Addresses

Primary practice location

702 W Chestnut St
Bloomington, IL 61701-2814

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786

Other practice location 1

2540 College and University
Normal, IL 61790-2540
Phone (309) 438-2956

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
I20070314000395 IL Practitioner - Emergency Medicine 1355444266 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036081580ILMDFamily Medicine Physician
336.043935ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc. CurrentSince Feb 25, 2019 Accepting new patients
Chestnut Health Systems Inc CurrentSince Feb 25, 2019 Accepting new patients
Prairie Emergency Group, LTD. Past Accepting new patients
Chestnut Health Systems, Inc Past Accepting new patients
Central Illinois Neuroradiology, LTD Past Accepting new patients

Locations

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

702 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

720 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

Interoperability endpoints

  • Direct secure messaging: victoria.brockhouse@cfhc.eclinicaldirectplus.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1790744555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-567-1400",
            "fax_number": "309-557-1461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 College and University",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617902540",
            "country_code": "US",
            "telephone_number": "309-438-2956",
            "fax_number": "309-438-3689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKHOUSE",
        "first_name": "VICTORIA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "336.043935",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036081580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.