| NPI | 1245415850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J. MACK Owner 630-390-8360 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016003689) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2020-05-07 |