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 |