| NPI | 1346752656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MARY-DANIELLE LEE Practice Administrator 224-227-6973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016005367) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |