institution
Prairie Rock Foot & Ankle Clinic Ltd
Foot & Ankle Surgery Podiatrist in Manteno, Illinois
NPI 1437136926

Prairie Rock Foot & Ankle Clinic Ltd is a Foot & Ankle Surgery Podiatrist based in Manteno, IL and is specialized in Foot & Ankle Surgery. Prairie Rock Foot & Ankle Clinic Ltd practices in Manteno, IL. The NPI Number for Prairie Rock Foot & Ankle Clinic Ltd is 1437136926 and holds a License No. (Illinois).

The current practice location address for Prairie Rock Foot & Ankle Clinic Ltd is 2825 West Division Street, Manteno, IL and can be reached out via phone at 815-468-7117 and via fax at 815-468-7510.

Location: 2825 West Division Street, Manteno, IL, 60950-1518
institution
Provider Profile Details
NPI Number
1437136926
Provider Name
Prairie Rock Foot & Ankle Clinic Ltd
Credential
Provider Entity Type
Organization
Address
2825 West Division Street, Manteno, IL, 60950-1518
Phone Number
815-468-7117
Fax Number
815-468-7510
Provider Enumeration Date
12/27/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
203799 01 IL MEDICARE GROUP NUMBER
480034698 01 IL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
2825 West Division Street
City
State
Zip
60950-1518
Phone Number
815-468-7117
Fax Number
815-468-7510
person
Provider Business Mailing Address Details
Address
2825 West Division Street
City
State
Zip
60950-1518
Phone Number
815-468-7117
Fax Number
815-468-7510
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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