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Organization
PREMIER MEDICAL GROUP, LLC
Active
Organization
PREMIER MEDICAL GROUP, LLC
Active
Other names
Scott O'Connor, DPM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HESSE (EXECUTIVE ADMINISTRATOR)
(309) 662-6200
Entity
Organization
Contact information
Practice address
1512 W REYNOLDS ST STE A, PONTIAC, IL 61764-9788
(815) 842-6551
(815) 844-4106
Mailing address
1512-A REYNOLDS, PONTIAC, IL 61764-1745
(815) 842-6551
(815) 844-4106
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-005106
IL
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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