Organization
PREMIER MEDICAL GROUP, LLC
Active
Other names
Scott O'Connor, DPM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HESSE (EXECUTIVE ADMINISTRATOR)
(309) 662-6200
Entity
Organization
Contact information
Practice address
1512 W REYNOLDS ST STE A, PONTIAC, IL 61764-9788
(815) 842-6551
(815) 844-4106
Mailing address
1512-A REYNOLDS, PONTIAC, IL 61764-1745
(815) 842-6551
(815) 844-4106
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-005106
IL
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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