Organization
PRO PODIATRY, LLC
Active
Other names
Premier Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT OCONNOR DPM (MEMBER)
(309) 807-0384
Entity
Organization
Contact information
Practice address
2501 E COLLEGE AVE STE C, BLOOMINGTON, IL 61704-2484
(309) 807-0384
Mailing address
1512 W REYNOLDS ST STE A, PONTIAC, IL 61764-9788
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005106
IL
Other
Enumeration date
12/07/2016
Last updated
09/01/2022
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