Prairie Podiatry L.l.c.

NPI #1144349747 in Springfield, Illinois

Provider Information

NPI Number: 1144349747
Entity Type: Organization
Organization Name: Prairie Podiatry L.l.c.
Primary Specialty: Podiatrist
Enumeration Date: Mar 28, 2007
Last Updated: Feb 22, 2022

Practice Location

Address: 2070 W ILES AVE
City: Springfield
State: Illinois
ZIP Code: 62704-4174
Phone: (217) 698-6228

Authorized Official

Name: DR. JOHN ANDREW SHOUDEL, DPM
Title: OWNER
Phone: (217) 698-6228

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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