Individual
TODD SNOEYINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3038
Mailing address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3000
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005069
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
01
—
480033968
RAILROAD
IL
01
—
IL2613
MEDICARE GROUP PTAN
IL
Enumeration date
09/25/2006
Last updated
12/17/2009
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