| Pro Podiatry, Llc | |
| 
					1512 W Reynolds St, Suite A, Pontiac, IL 61764-9781  | |
| (815) 842-6551 | |
| Not Available | 
| Full Name | Pro Podiatry, Llc | 
|---|---|
| Type | Facility | 
| Speciality | Podiatrist - Foot & Ankle Surgery | 
| Location | 1512 W Reynolds St, Pontiac, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1609064369 | NPI | - | NPPES | 
| K00030 | Other | IL | MEDICARE INDIVIDUAL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 016005106 (Illinois) | Primary | 
| Provider Name | Scott B Oconnor | 
|---|---|
| Provider Type | Practitioner - Podiatry | 
| Provider Identifiers | NPI Number: 1992792261 PECOS PAC ID: 4385602366 Enrollment ID: I20041222000065  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pro Podiatry, Llc 1512 W Reynolds St, Suite A, Pontiac, IL 61764-9781 Ph: () -  | Pro Podiatry, Llc 1512 W Reynolds St, Suite A, Pontiac, IL 61764-9781 Ph: (815) 842-6551  | 
Premier Medical Group, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1512 W Reynolds St Ste A, Pontiac, IL 61764 Phone: 815-842-6551 Fax: 815-844-4106  | |
Dr. Scott B O'connor, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1512 W Reynolds St Ste A, Pontiac, IL 61764 Phone: 815-842-6551  |