| Northern Illinois Podiatry Pc | |
|
521 W Main St, Freeport, IL 61032 | |
| (815) 233-0211 | |
| (815) 233-0214 |
| Full Name | Northern Illinois Podiatry Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 521 W Main St, Freeport, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740495944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (Illinois) | Primary |
| Provider Name | Carol A Wisniewski |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316961675 PECOS PAC ID: 1557448800 Enrollment ID: I20080410000372 |
| Provider Name | Ronald K Dickey |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1730103094 PECOS PAC ID: 3274610522 Enrollment ID: I20080410000410 |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Illinois Podiatry Pc 521 W Main St, Freeport, IL 61032 Ph: (815) 233-0211 | Northern Illinois Podiatry Pc 521 W Main St, Freeport, IL 61032 Ph: (815) 233-0211 |
Carol Ann Wisniewski, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 521 W Main St, Freeport, IL 61032 Phone: 815-233-0211 Fax: 815-233-0214 | |
Kenneth S Stone Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1717 W Church St, Freeport, IL 61032 Phone: 815-235-4231 Fax: 815-233-9531 | |
Roland A. Tolliver Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1201 W Empire St, Freeport, IL 61032 Phone: 815-232-8015 Fax: 815-235-1376 | |
Ronald Keith Dickey, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 521 W Main St, Freeport, IL 61032 Phone: 815-233-0211 Fax: 815-233-0214 | |
Dr. Roland A Tolliver Jr., D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: Freeport Podiatry Services, Llc, 1201 West Empire Street, Freeport, IL 61032 Phone: 815-232-8015 Fax: 815-235-1376 |