| NPI | 1194043539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIF MOUSSA MATOUK President 815-534-5724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: IL 016-005096) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2012-03-15 |