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PEKIN PODIATRIC MEDICAL CENTER P.C NPI 1518142439


NPI Information

NPI: 1518142439
Provider Name: PEKIN PODIATRIC MEDICAL CENTER, P.C
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
1505 VALLE VISTA BLVD
PEKIN, IL
ZIP 61554
Phone: (309) 347-6121
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PEKIN PODIATRIC MEDICAL CENTER, P.C is a podiatrist in Pekin, IL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. PEKIN PODIATRIC MEDICAL CENTER, P.C NPI is 1518142439. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1505 VALLE VISTA BLVD
PEKIN, IL
ZIP 61554-245
Phone: (309) 347-6121
Fax: (309) 347-8010

The provider's authorized official is Chao Vang .
The authorized official title is President and has the following contact phone number (309) 347-6121.

The enumeration date for this NPI number is 1/9/2008 and was last updated on 4/30/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist016004868ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1U71068MEDICARE UPINILLINOIS
21274110001MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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