| NPI | 1407392418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD MACK President 708-721-0387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5325) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |