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Organization

MIDWEST FOOT AND ANKLE SPECIALISTS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS JOHN FREEL DPM (OWNER)
(217) 223-3668
Entity
Organization

Contact information

Practice address
3740 E LAKE CTR, QUINCY, IL 62305-5805
(217) 223-3668
(217) 223-3412
Mailing address
3740 E LAKE CTR, QUINCY, IL 62305-5805
(217) 223-3668
(217) 223-3412

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
060228083
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
132005
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/11/2007
Last updated
05/12/2008
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