| Premier Medical Group, Llc | |
| 
					1512 W Reynolds St Ste A, Pontiac, IL 61764-9788  | |
| (815) 842-6551 | |
| (815) 844-4106 | 
| Full Name | Premier Medical Group, Llc | 
|---|---|
| Type | Facility | 
| Speciality | Podiatrist | 
| Location | 1512 W Reynolds St Ste A, Pontiac, Illinois | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497054720 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 213E00000X | Podiatrist | 016-005106 (Illinois) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Premier Medical Group, Llc 1512-a Reynolds, Pontiac, IL 61764-1745 Ph: (815) 842-6551  | Premier Medical Group, Llc 1512 W Reynolds St Ste A, Pontiac, IL 61764-9788 Ph: (815) 842-6551  | 
Pro Podiatry, Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 1512 W Reynolds St, Suite A, Pontiac, IL 61764 Phone: 815-842-6551  | |
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  |