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Pro Podiatry, Llc
Foot & Ankle Surgery Podiatrist in Pontiac, Illinois
NPI 1609064369

Pro Podiatry, Llc is a Foot & Ankle Surgery Podiatrist based in Pontiac, IL and is specialized in Foot & Ankle Surgery. Pro Podiatry, Llc practices in Pontiac, IL. The NPI Number for Pro Podiatry, Llc is 1609064369 and holds a License No. 016005106 (Illinois).

The current practice location address for Pro Podiatry, Llc is 1512 W Reynolds St, Pontiac, IL and can be reached out via phone at 815-842-6551.

Location: 1512 W Reynolds St, Pontiac, IL, 61764-9781
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1609064369
Provider Name
Pro Podiatry, Llc
Credential
Provider Entity Type
Organization
Address
1512 W Reynolds St, Pontiac, IL, 61764-9781
Phone Number
815-842-6551
Fax Number
Provider Enumeration Date
10/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
K00030 01 IL MEDICARE INDIVIDUAL
institution
Provider Business Practice Location Address Details
Address
1512 W Reynolds St
City
Pontiac
State
Illinois
Zip
61764-9781
Phone Number
815-842-6551
Fax Number
person
Provider Business Mailing Address Details
Address
1512 W Reynolds St
City
Pontiac
State
Illinois
Zip
61764-9781
Phone Number
815-842-6551
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
016005106 (Illinois)
Definition
Definition to come...
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