Healther Providers Data Logo


Provider Type Icon

PRO PODIATRY LLC NPI 1609064369


NPI Information

NPI: 1609064369
Provider Name: PRO PODIATRY, LLC

Doing Business As: CENTRAL ILLINOIS FOOT & ANKLE CENTER

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1512 W REYNOLDS ST
SUITE A
PONTIAC, IL
ZIP 61764
Phone: (815) 842-6551
Get Directions

PRO PODIATRY, LLC is a foot and ankle surgery podiatrist in Pontiac, IL. PRO PODIATRY, LLC NPI is 1609064369. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Central Illinois Foot & Ankle Center.

The provider's business location address is:

1512 W REYNOLDS ST
SUITE A
PONTIAC, IL
ZIP 61764-781
Phone: (815) 842-6551

The provider's authorized official is Scott O'connor .
The authorized official title is Member and has the following contact phone number (815) 842-6551.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 12/9/2016.


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 Surgery016005106ILLINOISYes

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
1K00030OTHERILLINOISMEDICARE INDIVIDUAL
2206264MEDICARE PINILLINOIS
3U70573MEDICARE UPINILLINOIS
44811350001MEDICARE NSCILLINOIS

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
Remove or sync iconNPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI
Next NPI »