St. Charles Podiatry Assoc | |
2210 Dean St, Suite C, St Charles, IL 60175-1066 | |
(630) 377-5001 | |
(630) 377-5021 |
Full Name | St. Charles Podiatry Assoc |
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Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 2210 Dean St, St Charles, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144438011 | NPI | - | NPPES |
307570 | Other | MEDICARE ID | |
004515235 | Other | IL | BCBS PROV# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | 016002699 (Illinois) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 016002685 (Illinois) | Primary |
Provider Name | Ernest V Isadore |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1558379008 PECOS PAC ID: 9335211127 Enrollment ID: I20080728000763 |
Mailing Address | Practice Location Address |
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St. Charles Podiatry Assoc 2210 Dean St, Suite C, St Charles, IL 60175-1066 Ph: (630) 377-5001 | St. Charles Podiatry Assoc 2210 Dean St, Suite C, St Charles, IL 60175-1066 Ph: (630) 377-5001 |
Dr. Ernest V. Isadore, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2210 Dean Street, Suite C, St Charles, IL 60175 Phone: 630-377-5001 Fax: 630-377-5021 | |
Eric Baldric Bettag, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2320 Dean St Ste 104, St Charles, IL 60175 Phone: 630-584-4200 Fax: 630-584-4257 | |
St. Charles Foot And Ankle Center Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 2320 Dean St Ste 104, St Charles, IL 60175 Phone: 630-584-4200 |