| NPI | 1043202559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORTUNEE MASSUDA Medical Director & CEO 847-424-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ES0131X Podiatrist, Foot Surgery | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 213EP0504X Podiatrist, Public Medicine | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2008-07-03 |