Organization
FOOT & 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
1515 W WALNUT ST, SUITE 12, JACKSONVILLE, IL 62650-1150
(217) 243-1101
(217) 243-5003
Mailing address
1515 W WALNUT ST, SUITE 12, JACKSONVILLE, IL 62650-1150
(217) 243-1101
(217) 243-5003
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06932011
BCBS
IL
01
—
DA1788
GROUP RAILROAD MEDICARE #
IL
Enumeration date
09/28/2006
Last updated
11/01/2012
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