Organization
FOOT AND ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FLEISCHLI DPM (PRESIDENT)
(217) 243-1101
Entity
Organization
Contact information
Practice address
100 W 15TH ST, BEARDSTOWN, IL 62618-1774
(217) 323-2707
Mailing address
1515 W WALNUT ST STE 12, JACKSONVILLE, IL 62650-1158
(217) 243-1101
(217) 243-5003
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
016004737
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06932011
BCBS
IL
01
—
DA1788
GROUP RAILROAD MEDICARE #
IL
Enumeration date
03/19/2007
Last updated
09/07/2012
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