| NPI | 1316117211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORTUNEE MASSUDA Medical Director/CEO 773-752-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2011-12-17 |