person
Mr. Dennis Wayne Dillard, CPED,CTO
Orthotic Fitter in Peoria, Illinois
NPI 1275667115

Dennis Wayne Dillard is a Orthotic Fitter based in Hanna City, IL. Dennis Wayne Dillard practices in Peoria, IL and has the professional credentials of CPED,CTO. The NPI Number for Dennis Wayne Dillard is 1275667115 and holds a License No. 212-000127 (Illinois).

The current practice location address for Dennis Wayne Dillard is 741 W Main St, Peoria, IL and can be reached out via phone at 309-676-2276. You can also correspond with Dennis Wayne Dillard through the mailing address at 10823 W SMITHVILLE RD, HANNA CITY, IL - 61536-9711 (mailing address contact number: 309-565-7133).

Location: 741 W Main St, Peoria, IL, 61536-9711
person
Provider Profile Details
NPI Number
1275667115
Provider Name
Dennis Wayne Dillard
Credential
CPED,CTO
Provider Entity Type
Individual
Gender
Male
Address
741 W Main St, Peoria, IL, 61536-9711
Phone Number
309-676-2276
Fax Number
Provider Enumeration Date
03/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CPED1563 01 IL AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS, AND PEDORTHICS, INC.
212-000127 01 IL STATE LICENSED PEDORTHIST
institution
Provider Business Practice Location Address Details
Address
741 W Main St
City
State
Zip
61606-2017
Phone Number
309-676-2276
Fax Number
person
Provider Business Mailing Address Details
Address
741 W Main St
City
State
Zip
61606-2017
Phone Number
309-676-2276
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Orthotic Fitter
Speciality
-
Taxonomy
License No.
212-000127 (Illinois)
Definition
An individual trained in the management of fitting prefabricated orthoses.
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