DR. ABIGAIL ALAYNE MAHONEY DPM NPI 1710996103

NPI Information

NPI: 1710996103
Provider Name: DR. ABIGAIL ALAYNE MAHONEY, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
5017 N GLEN PARK PLACE RD
PEORIA, IL
ZIP 61614
Phone: (309) 691-1589
Get Directions

DR. Abigail Alayne Mahoney, DPM is a foot and ankle surgery podiatrist in Peoria, IL. DR. Abigail Alayne Mahoney, DPM NPI is 1710996103. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5017 N GLEN PARK PLACE RD
PEORIA, IL
ZIP 61614-677
Phone: (309) 691-1589
Fax: (309) 692-2032

The NPI 1710996103 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 8/5/2006 and was last updated on 9/19/2016.

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
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	016005175	ILLINOIS	Yes

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
1	K32173	MEDICARE ID-TYPE UNSPECIFIED	IDAHO
2	732420	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
3	K32172	MEDICARE UPIN	ILLINOIS
4	VO3839	MEDICARE UPIN	ILLINOIS
5	732422	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
6	016005175	MEDICAID	ILLINOIS

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: 4/28/2024

NPI Synchronization or Removal

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