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
615 N PROMENADE ST, HAVANA, IL 62644-1243
(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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
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
08/22/2020
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