| NPI | 1346541158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY GAIL KWIECINSKI Owner/President 847-816-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2021-12-28 |