| NPI | 1174060917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE S MICHAEL Chief Operations Officer 847-504-5002 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 060005901) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2021-01-22 |