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Mark Alan Smith, DPM
Podiatrist in Peoria, Illinois
NPI 1093885378

Mark Alan Smith is a Podiatrist based in Peoria, IL. Mark Alan Smith practices in Peoria, IL and has the professional credentials of DPM. The NPI Number for Mark Alan Smith is 1093885378 and holds a License No. 016004790 (Illinois).

The current practice location address for Mark Alan Smith is 3322 W Willow Knolls Dr, Peoria, IL and can be reached out via phone at 309-691-5800 and via fax at 309-691-1336.

Location: 3322 W Willow Knolls Dr, Peoria, IL, 61614
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093885378
Provider Name
Mark Alan Smith
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
3322 W Willow Knolls Dr, Peoria, IL, 61614
Phone Number
309-691-5800
Fax Number
309-691-1336
Provider Enumeration Date
11/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
016004790 05 IL
0007215174 01 IL BLUE CROSS BLUE SHIELD
928270 01 IL MEDICARE PROVIDER
480022534 01 IL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
3322 W Willow Knolls Dr
City
Peoria
State
Illinois
Zip
61614
Phone Number
309-691-5800
Fax Number
309-691-1336
person
Provider Business Mailing Address Details
Address
3322 W Willow Knolls Dr
City
Peoria
State
Illinois
Zip
61614
Phone Number
309-691-5800
Fax Number
309-691-1336
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
016004790 (Illinois)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
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