Individual provider · NPI-1
Wyatt Andrew Verplaetse, MD
Allergy & Immunology · Peoria, IL
NPI number1629508965
StatusActive
Last updated in NPPESFeb 9, 2026
Details
- NPI
- 1629508965
- Entity type
- Individual (NPI-1)
- Name
- Wyatt Andrew Verplaetse
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 19, 2017
- Certification date
- Feb 9, 2026
- Last updated
- Feb 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207K00000X | Allergy & Immunology | 207K00000X | IL | Yes |
| 208000000X | Pediatrics | 125.071367 | IL | |
| 207K00000X | Allergy & Immunology | 2022026074 | MO | |
| 207R00000X | Internal Medicine | 036155926 | IL |
Practice location
1001 Main St Ste 200Peoria, IL 61606-2035
Phone 309-308-2010 · Fax 309-671-2167
Mailing address
1001 Main St Ste 200Peoria, IL 61606-2035
Phone 309-308-2010 · Fax 309-671-2167
Other practice locations
530 Ne Glen Oak Ave
Peoria, IL 61637-0001
Peoria, IL 61637-0001
Phone 309-655-3863
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