Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
ILLINOIS VALLEY PODIATRY GROUP PC
Active
Organization
ILLINOIS VALLEY PODIATRY GROUP PC
Active
Other names
Illinois Valley Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS KEVIN BRATTAIN DPM (PODIATRIST)
(309) 691-5800
Entity
Organization
Contact information
Practice address
3322 W WILLOW KNOLLS, PEORIA, IL 61614
(309) 691-5800
(309) 691-1336
Mailing address
3322 W WILLOW KNOLLS, PEORIA, IL 61614
(309) 691-5800
(309) 691-1336
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007215174
BLUE CROSS BLUE SHIELD
IL
01
—
CM5560
RAILROAD MEDICARE
IL
Enumeration date
04/16/2007
Last updated
02/21/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up