Organization
EICKMEIER FOOT AND ANKLE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY EICKMEIER DPM (OWNER)
(217) 352-2573
Entity
Organization
Contact information
Practice address
411 DEVONSHIRE DR, CHAMPAIGN, IL 61820-7286
(217) 352-2573
Mailing address
1806 N MARKET ST, CHAMPAIGN, IL 61822-1312
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004729
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811903651
—
IL
Enumeration date
03/25/2016
Last updated
12/18/2018
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