Manteno Foot & Ankle Clinic

LBN: Prairie Rock Foot & Ankle Clinic Ltd
Manteno Foot & Ankle Clinic is an health care organization with primary practice located at 2825 West Division Street , Manteno IL 60950-1518. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as the primary health care specialty. Prairie Rock Foot & Ankle Clinic Ltd can be contacted via phone (815) 468-7117, or through Lesage, Alene D via phone (815) 468-7117.

Contact Information

Primary practice address
2825 West Division Street Manteno IL 60950-1518
Phone: (815) 468-7117
Fax: (815) 468-7510
Website:
Map and Directions
Authorized official contact:
Name: Lesage, Alene D Certified Medical Assistant (CMA)
Phone: (815) 468-7117

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X Illinois

Profile Details

NPI number 1437136926
LBN Legal business name Prairie Rock Foot & Ankle Clinic Ltd
DBA Doing business as Manteno Foot & Ankle Clinic
Authorized official Lesage, Alene D Certified Medical Assistant (CMA)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2005
Last updated Jul 21st, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437136926 NPPES
Illinois Other 203799 MEDICARE GROUP NUMBER
Illinois Other 480034698 MEDICARE GROUP NUMBER

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