Individual provider · Type 1 NPI

Anthony V. Deceanne, DPM

Foot & Ankle Surgery Podiatrist · Peoria, IL

NPI number 1083613293 Active

Practice location

5017 N Glen Park Place Rd
Peoria, IL 61614-4677

Call (309) 691-1589 Map

Fax (309) 692-2032

Mailing address

435 W Detweiller Dr
Peoria, IL 61615-2116

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103X016004489 (IL)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1083613293

Anthony V. Deceanne, DPM's National Provider Identifier is 1083613293, issued on Jul 19, 2005. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Peoria, IL. The record was last updated on Mar 29, 2010.