| NPI | 1770027930 |
|---|---|
| Doing Business As | PREMIER PODIATRY |
| Entity Type | Organization |
| Authorized Contact | SCOTT OCONNOR Member 309-807-0384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005106) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2022-09-01 |