| NPI | 1659529311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JOMARIE LOCKWOOD Owner/President 309-661-9975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005357) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2022-09-01 |