Individual
DR. MELISSA JOMARIE LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
10 HEARTLAND DR, SUITE B, BLOOMINGTON, IL 61704-7741
(309) 585-0523
Mailing address
1518 BECKENHAM DR, BLOOMINGTON, IL 61704-7629
(216) 392-0677
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
08/14/2007
Last updated
09/15/2009
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