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Contact Information

ILLINOIS VALLEY PODIATRY GROUP PC
3322 W WILLOW KNOLLS
PEORIA, IL61614
 Phone: 309-691-5800
 Fax: 309-691-1336
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Surgery, Foot

213ES0131X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ILLINOIS VALLEY PODIATRY GROUP PC · (Female)

NPI Number 1750506846
Status Active
Credentials
Entity Individual
Enumeration date 04/16/2007
Last updated 02/21/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL Other 0007215174 BLUE CROSS BLUE SHIELD
  • IL Other CM5560 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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