Healthcare Provider Details

I. General information

NPI: 1013823046
Provider Name (Legal Business Name): COLLIN DAVID ALLEN APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 N KNOXVILLE AVE
PEORIA IL
61614-5098
US

IV. Provider business mailing address

40 CIRCLE DR
PEKIN IL
61554-2400
US

V. Phone/Fax

Practice location:
  • Phone: 309-691-1000
  • Fax:
Mailing address:
  • Phone: 309-241-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: