Prairie Podiatry L.L.C.

LBN: Prairie Podiatry L.L.C.
Prairie Podiatry L.L.C. is an health care organization with primary practice located at 2070 W Iles Ave , Springfield IL 62704-4174. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Prairie Podiatry L.L.C. can be contacted via phone (217) 698-6228, or through Shoudel, John Andrew via phone (217) 698-6228.

Contact Information

Primary practice address
2070 W Iles Ave Springfield IL 62704-4174
Phone: (217) 698-6228
Fax: (217) 698-7241
Website:
Map and Directions
Authorized official contact:
Name: Shoudel, John Andrew Doctor of Podiatric Medicine (DPM)
Phone: (217) 698-6228

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004443 Illinois

Profile Details

NPI number 1144349747
LBN Legal business name Prairie Podiatry L.L.C.
DBA Doing business as
Authorized official Shoudel, John Andrew Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 28th, 2007
Last updated Feb 22nd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1144349747 NPPES
Illinois Other 60101308 BLUE CROSS

Popular Providers