| NPI | 1184184186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VADIM GOSHKO Dpm / Owner 773-205-0106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |