| NPI | 1164541025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE NANCY MEJIA Billing Manager 312-337-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016-004401) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 06005134) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |