# PRAIRIE ROCK FOOT & ANKLE CLINIC LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Manteno Foot & Ankle Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437136926
- **Authorized official:** MS. ALENE D LESAGE CMA (OFFICE MANAGER)
- **Authorized official phone:** (815) 468-7117

## Contact information

- **Practice address:** 2825 WEST DIVISION STREET, MANTENO, IL 60950-1518
- **Practice address phone:** (815) 468-7117
- **Practice address fax:** (815) 468-7510
- **Mailing address:** 2825 WEST DIVISION STREET, MANTENO, IL 60950-1518
- **Mailing address phone:** (815) 468-7117
- **Mailing address fax:** (815) 468-7510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | IL | Yes |

## Other

- **Enumeration date:** 12/27/2005
- **Last updated:** 07/21/2022