NPI 1003540220

Gayana Wanniarachchi

Practitioner Foot & Ankle Surgery Podiatrist Dixon, IL

Practice location

Address: 215 E 1st St STE 111, Dixon, IL 61021-3198
Phone: (815) 345-5677

Registered specialties

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 135.001170 (IL)

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Registry record

NPI: 1003540220
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jul 2022
Record last updated: 13 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.