| NPI | 1205905916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSYN CONTRERAS Director, Quality Assurance 773-751-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2012-10-09 |