Organization
HEARTLAND FOOT & ANKLE ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA JOMARIE LOCKWOOD D.P.M. (OWNER/PRESIDENT)
(309) 661-9975
Entity
Organization
Contact information
Practice address
10 HEARTLAND DR, SUITE B, BLOOMINGTON, IL 61704-7775
(309) 661-9975
(309) 661-9920
Mailing address
10 HEARTLAND DR, SUITE B, BLOOMINGTON, IL 61704-7741
(309) 661-9975
(309) 661-9920
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016.005357
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005357
—
IL
01
—
0732240001
DMERC # WITH PPG
—
Enumeration date
09/05/2008
Last updated
09/01/2022
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