# PRO PODIATRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Podiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770027930
- **Authorized official:** DR. SCOTT OCONNOR DPM (MEMBER)
- **Authorized official phone:** (309) 807-0384

## Contact information

- **Practice address:** 2501 E COLLEGE AVE STE C, BLOOMINGTON, IL 61704-2484
- **Practice address phone:** (309) 807-0384
- **Mailing address:** 1512 W REYNOLDS ST STE A, PONTIAC, IL 61764-9788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 016005106 | IL | Yes |

## Other

- **Enumeration date:** 12/07/2016
- **Last updated:** 09/01/2022