Central Illinois Foot & Ankle Center | |
1512 W Reynolds St, Suite A, Pontiac, IL 61764-9781 | |
(815) 842-6551 | |
Not Available |
Full Name | Central Illinois Foot & Ankle Center |
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Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 1512 W Reynolds St, Pontiac, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1609064369 | NPI | - | NPPES |
K00030 | Other | IL | MEDICARE INDIVIDUAL |
Taxonomy | Type | License (State) | Status |
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213ES0103X | Podiatrist - Foot & Ankle Surgery | 016005106 (Illinois) | Primary |
Provider Name | Scott B Oconnor |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1992792261 PECOS PAC ID: 4385602366 Enrollment ID: I20041222000065 |
Mailing Address | Practice Location Address |
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Central Illinois Foot & Ankle Center 1512 W Reynolds St, Suite A, Pontiac, IL 61764-9781 Ph: () - | Central Illinois Foot & Ankle Center 1512 W Reynolds St, Suite A, Pontiac, IL 61764-9781 Ph: (815) 842-6551 |
Scott O'connor, Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1512 W Reynolds St Ste A, Pontiac, IL 61764 Phone: 815-842-6551 Fax: 815-844-4106 | |
Dr. Scott B O'connor, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1512 W Reynolds St Ste A, Pontiac, IL 61764 Phone: 815-842-6551 |