| NPI | 1427123926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY PANCAMO Billing Supervisor 630-333-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005007) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2010-02-10 |