| Prairie Podiatry L.l.c. | |
|
2070 W Iles Ave, Springfield, IL 62704-4174 | |
| (217) 698-6228 | |
| (217) 698-7241 |
| Full Name | Prairie Podiatry L.l.c. |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 2070 W Iles Ave, Springfield, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144349747 | NPI | - | NPPES |
| 60101308 | Other | IL | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 016004443 (Illinois) | Primary |
| Provider Name | Richard L Brown |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1275531188 PECOS PAC ID: 1153445291 Enrollment ID: I20100826000750 |
| Provider Name | Thomas J Cockayne |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1063820231 PECOS PAC ID: 6305115890 Enrollment ID: I20170626002396 |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Podiatry L.l.c. 2070 W Iles Ave, Springfield, IL 62704-4174 Ph: (217) 698-6228 | Prairie Podiatry L.l.c. 2070 W Iles Ave, Springfield, IL 62704-4174 Ph: (217) 698-6228 |
Dr. Marla Kay Wilson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1522 S 5th St, Springfield, IL 62703 Phone: 217-522-3622 Fax: 217-522-3046 | |
Siebert Podiatry Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 102 S Grand Ave W, Springfield, IL 62704 Phone: 217-523-4539 | |
Dr. Grant Wilson Gonzalez, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2921 Montvale Dr, Springfield, IL 62704 Phone: 217-787-2700 Fax: 217-787-2715 | |
John M Sigle, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2921 Montvale Dr, Springfield, IL 62704 Phone: 217-793-9600 Fax: 217-793-9445 | |
Foot & Ankle Associates Of Central Il Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1603 West Washington, Springfield, IL 62702 Phone: 217-744-7529 | |
Foot & Ankle Associates Of Central Il Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 3631 S 6th St, Springfield, IL 62703 Phone: 217-535-3685 |