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FOOT & ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC NPI 1043302144


NPI Information

NPI: 1043302144
Provider Name: FOOT & ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1515 W WALNUT ST
SUITE 12
JACKSONVILLE, IL
ZIP 62650
Phone: (217) 243-1101
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FOOT & ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC is a foot and ankle surgery podiatrist in Jacksonville, IL. FOOT & ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC NPI is 1043302144. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1515 W WALNUT ST
SUITE 12
JACKSONVILLE, IL
ZIP 62650-150
Phone: (217) 243-1101
Fax: (217) 243-5003

The provider's authorized official is John Fleischli .
The authorized official title is President and has the following contact phone number (217) 243-1101.

The enumeration date for this NPI number is 9/28/2006 and was last updated on 11/1/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle SurgeryILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14974780001MEDICARE NSCILLINOIS
206932011OTHERILLINOISBCBS
3DA1788OTHERILLINOISGROUP RAILROAD MEDICARE #
4205953MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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