IndividualActive
Anthony Deceanne, DPM
NPI 1083613293 · Foot & Ankle Surgery Podiatrist · Peoria, IL
Provider details
- NPI number
- 1083613293
- Entity type
- Individual
- Primary specialty
- Foot & Ankle Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- License
- 016004489 (IL)
Practice location
5017 N Glen Park Place Rd
Peoria, IL 61614-4677
Phone: (309) 691-1589
Fax: (309) 692-2032
Mailing address
435 W Detweiller Dr
Peoria, IL 61615-2116
Registry dates
- Enumerated
- 2005-07-19
- Last updated
- 2010-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.