Organization
REGIONAL FOOT CENTER LTD
Active
Organization
REGIONAL FOOT CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ROBERT KILLOUGH DPM (OWNER/PODIATRIST)
(217) 348-3339
Entity
Organization
Contact information
Practice address
1301 DEERPATH ROAD, CHARLESTON, IL 61920-8734
(217) 348-3339
(217) 348-3340
Mailing address
1301 DEERPATH ROAD, CHARLESTON, IL 61920-8734
(217) 348-3339
(217) 348-3340
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
16005103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015-32005
BLUE CROSS BLUE SHIELD
IL
05
—
016005103
—
IL
01
—
8958903
CIGNA
IL
01
—
P00082665
PALMETTO
IL
Enumeration date
09/20/2006
Last updated
07/13/2009
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