| NPI | 1750506846 |
|---|---|
| Other Name | ILLINOIS VALLEY PODIATRY |
| Entity Type | Organization |
| Authorized Contact | THOMAS KEVIN BRATTAIN Podiatrist 309-691-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 213ES0131X Podiatrist, Foot Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2013-02-21 |