| Dr Grant Wilson Gonzalez, DPM | |
|
2921 Montvale Dr, Springfield, IL 62704-5359 | |
| (217) 787-2700 | |
| (217) 787-2715 |
| Full Name | Dr Grant Wilson Gonzalez |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 13 Years |
| Location | 2921 Montvale Dr, Springfield, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164856704 | NPI | - | NPPES |
| 016005651 | Other | IL | STATE OF ILLINOIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | POD001231 (Georgia) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 016005651 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Carlinville Area Hospital | Carlinville, IL | Hospital |
| Decatur Memorial Hospital | Decatur, IL | Hospital |
| St Marys Hospital | Decatur, IL | Hospital |
| St Johns Hospital | Springfield, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Foot And Ankle Center Of Illinois Pc | 9638347586 | 3 |
| Provider Name | Foot & Ankle Center Of Illinois Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1598058547 PECOS PAC ID: 9638347586 Enrollment ID: O20110719000773 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Grant Wilson Gonzalez, DPM 2921 Montvale Dr, Springfield, IL 62704-5359 Ph: (217) 787-2700 | Dr Grant Wilson Gonzalez, DPM 2921 Montvale Dr, Springfield, IL 62704-5359 Ph: (217) 787-2700 |
Dr. Marla Kay Wilson, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1522 S 5th St, Springfield, IL 62703 Phone: 217-522-3622 Fax: 217-522-3046 | |
Scott David Schleunes, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1301 S Koke Mill Rd, Springfield, IL 62711 Phone: 217-547-9100 Fax: 217-547-9236 | |
Siebert Podiatry Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 102 S Grand Ave W, Springfield, IL 62704 Phone: 217-523-4539 | |
Prairie Podiatry L.l.c. Podiatrist Medicare: Medicare Enrolled Practice Location: 2070 W Iles Ave, Springfield, IL 62704 Phone: 217-698-6228 Fax: 217-698-7241 | |
Orthopaedic Center Of Il Podiatrist Medicare: Medicare Enrolled Practice Location: 1301 S Koke Mill Rd, Springfield, IL 62711 Phone: 217-547-9100 | |
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 |