# TRI COUNTY RADIOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346228848
- **Authorized official:** MR. W ROBERT COOPER (CMPE, CHBC)
- **Authorized official phone:** (309) 682-7750

## Contact information

- **Practice address:** 5409 N KNOXVILLE AVE, PEORIA, IL 61615
- **Practice address phone:** (309) 682-7750
- **Practice address fax:** (309) 682-7786
- **Mailing address:** PO BOX 3853, PEORIA, IL 61612-3853
- **Mailing address phone:** (800) 899-5757
- **Mailing address fax:** (314) 821-1833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | — |
| 2085B0100X | Body Imaging Physician | — | — | — |
| 2085N0904X | Nuclear Radiology Physician | — | NULL | — |
| 2085N0904X | Nuclear Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |

## Other

- **Enumeration date:** 01/04/2006
- **Last updated:** 09/11/2025