Illinois Valley Podiatry Group Pc in Peoria - Foot Surgery
Illinois Valley Podiatry Group Pc - NPI 1750506846
Illinois Valley Podiatry Group Pc is a Foot Surgery in Peoria, Illinois. Illinois Valley Podiatry Group Pc practices all healthcare services and medical treatments related to Foot Surgery. The NPI Number for Illinois Valley Podiatry Group Pc is 1750506846. The last update date is 2013-02-21.
Illinois Valley Podiatry Group Pc's current location address is 3322 W Willow Knolls, Peoria, Illinois. You can contact this provider via phone number 3096915800 and fax number 3096911336. The mailing address for Illinois Valley Podiatry Group Pc is 3322 W Willow Knolls, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Illinois Valley Podiatry Group Pc |
|---|---|
| Address | 3322 W Willow Knolls, Peoria, Illinois |
| Phone Number | 3096915800 |
| Fax Number | 3096911336 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PODIATRIST |
|---|---|
| Authorized Official Name | Brattain Kevin Thomas |
| Credentials | DPM |
| Telephone Number | 3096915800 |
NPI Number Detail
| NPI Number | 1750506846 |
|---|---|
| Provider Enumeration Date | 2007-04-16 |
| Last Updated Date | 2013-02-21 |
Provider Mailing Address Detail
| Address | 3322 W Willow Knolls |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 61614 |
| Phone Number | 3096915800 |
| Fax Number | 3096911336 |
Provider's Primary Taxonomy Detail
| Speciality | Foot Surgery |
|---|---|
| Taxonomy | 213Es0131X |
|
Definition: A doctor of podiatric medicine who specializes in performing foot and ankle surgeries. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7215174 | IL | BLUE CROSS BLUE SHIELD | |
| CM5560 | IL | RAILROAD MEDICARE |
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What is the unique identification code assigned to Illinois Valley Podiatry Group Pc by the Centers for Medicare & Medicaid Services?
The Illinois Valley Podiatry Group Pc has been issued the NPI (National Provider Identifier) 1750506846. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Illinois Valley Podiatry Group Pc located?
The Illinois Valley Podiatry Group Pc is located at 3322 W Willow Knolls, Peoria, IL 61614.
What is Illinois Valley Podiatry Group Pc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Illinois Valley Podiatry Group Pc is Foot Surgery, and the taxonomy code that categorizes this field of expertise is 213Es0131X.
When did Illinois Valley Podiatry Group Pc receive its 1750506846 assignment?
The Illinois Valley Podiatry Group Pc was assigned its 1750506846 on 2007-04-16, which is the date when this unique identifier was issued to the organization.
When was the information pertaining to Illinois Valley Podiatry Group Pc most recently updated or revised?
The details related to Illinois Valley Podiatry Group Pc, including its address, specialty, and other relevant information, were last updated or revised on 2013-02-21.
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