| St. Charles Podiatry Assoc | |
| 
					2210 Dean St, Suite C, St Charles, IL 60175-1066  | |
| (630) 377-5001 | |
| (630) 377-5021 | 
| Full Name | St. Charles Podiatry Assoc | 
|---|---|
| Type | Facility | 
| Speciality | Podiatrist - Foot & Ankle Surgery | 
| Location | 2210 Dean St, St Charles, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144438011 | NPI | - | NPPES | 
| 307570 | Other | MEDICARE ID | |
| 004515235 | Other | IL | BCBS PROV# | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 016002699 (Illinois) | Secondary | 
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 016002685 (Illinois) | Primary | 
| Provider Name | Ernest V Isadore | 
|---|---|
| Provider Type | Practitioner - Podiatry | 
| Provider Identifiers | NPI Number: 1558379008 PECOS PAC ID: 9335211127 Enrollment ID: I20080728000763  | 
| Mailing Address | Practice Location Address | 
|---|---|
| St. Charles Podiatry Assoc 2210 Dean St, Suite C, St Charles, IL 60175-1066 Ph: (630) 377-5001  | St. Charles Podiatry Assoc 2210 Dean St, Suite C, St Charles, IL 60175-1066 Ph: (630) 377-5001  | 
Dr. Ernest V. Isadore, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2210 Dean Street, Suite C, St Charles, IL 60175 Phone: 630-377-5001 Fax: 630-377-5021  | |
Eric Baldric Bettag, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2320 Dean St Ste 104, St Charles, IL 60175 Phone: 630-584-4200 Fax: 630-584-4257  | |
St. Charles Foot And Ankle Center Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 2320 Dean St Ste 104, St Charles, IL 60175 Phone: 630-584-4200  |