Organization
MCLEAN COUNTY FOOT & ANKLE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD PAUL DPM (CO-OWNER)
(309) 662-9001
Entity
Organization
Contact information
Practice address
3801 GE RD STE 4, BLOOMINGTON, IL 61704
(309) 662-9001
(309) 662-9005
Mailing address
3801 GE RD STE 4, BLOOMINGTON, IL 61704-4193
(309) 662-9001
(309) 662-9005
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005369
IL
Other
Enumeration date
04/23/2015
Last updated
01/11/2019
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