# MCLEAN COUNTY FOOT & ANKLE, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700273190
- **Authorized official:** GERALD PAUL DPM (CO-OWNER)
- **Authorized official phone:** (309) 662-9001

## Contact information

- **Practice address:** 3801 GE RD STE 4, BLOOMINGTON, IL 61704
- **Practice address phone:** (309) 662-9001
- **Practice address fax:** (309) 662-9005
- **Mailing address:** 3801 GE RD STE 4, BLOOMINGTON, IL 61704-4193
- **Mailing address phone:** (309) 662-9001
- **Mailing address fax:** (309) 662-9005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 016005369 | IL | Yes |

## Other

- **Enumeration date:** 04/23/2015
- **Last updated:** 01/11/2019