| |
509 Hamacher St, Suite 202, Waterloo, IL 62298-1592 | |
(618) 939-5979 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 509 Hamacher St, Waterloo, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871863662 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
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3505 College Ave, Suite B, Alton, IL 62002-5065 Ph: (618) 462-9695 | 509 Hamacher St, Suite 202, Waterloo, IL 62298-1592 Ph: (618) 939-5979 |