NPI Profile for MCLEAN COUNTY FOOT ANKLE LTD in BLOOMINGTON, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI Number | 1700273190 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/23/2015 | |
| Last updated | 01/11/2019 - About 7 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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