| NPI | 1457674566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY J THOMAS President Provider 708-429-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016-003064) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2010-09-22 |