| NPI | 1508031295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER JACOBSEN President 773-582-7100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: IL 016004485) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |