| NPI | 1285621235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M DISOMMA President 708-383-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 060007223) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016004585) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2013-07-17 |