Basic Information
| Provider Information | |||||||||
| NPI: | 1053516971 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILYEU | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2965 N MAIN ST | ||||||||
| Address2: | STE F | ||||||||
| City: | DECATUR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 625264392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2177683884 | ||||||||
| FaxNumber: | 2177683811 | ||||||||
| Practice Location | |||||||||
| Address1: | 4965 E LOST BRIDGE RD | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 625215139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2178645531 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2007 | ||||||||
| LastUpdateDate: | 12/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | 036127284 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | 036127284 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.