Foot and Ankle Associates of Central Illinois LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOOT AND ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC

Practice address

615 N Promenade St
Havana, IL 62644-1243

Phone

(217) 243-1101

Fax

(217) 243-5003

NPI assigned

Mar 19, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Fleischli, DPM

Title

President

Phone

(217) 243-1101

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey W Fleischli, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, IL
  • NPI 1467494310
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184748600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST",
            "address_2": "SUITE 12",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501150",
            "telephone_number": "217-243-1101",
            "fax_number": "217-243-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "217-243-1101",
            "fax_number": "217-243-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE ASSOCIATES OF CENTRAL ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLEISCHLI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-243-1101",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "06932011",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE #",
            "identifier": "DA1788",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey Mae Canete
• Rachel Lynn Davenport, PMHNP
• Dr. Strauman
• Kaitlyn Lee Fields, WHNP-BC
• Faythe Reyhan Flinn, LCSW
• Yvonne Lynn Fornoff, BSN, RN, CCM
• Marcie L. Ganson, PT, DPT, MBA
• Randall Joe Goodman II, DPT
• Becky Jane Hart, LCSW
• Havana Cusd 126

• Durable Medical Equipment & Medical Supplies in Havana, IL
• Providers in Havana, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.