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Organization
CFAC INCORPORATED
Active
Organization
CFAC INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILBERT MARC LEONARD DPM (OWNER)
(309) 212-3066
Entity
Organization
Contact information
Practice address
103 S JOHN ST, DWIGHT, IL 60420-1413
(815) 584-9000
Mailing address
9 MACKENZIE CT, BLOOMINGTON, IL 61704-7047
(309) 212-3066
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004981
IL
Other
Enumeration date
03/27/2007
Last updated
04/03/2013
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