| NPI | 1508365529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE DOMEK Owner 847-636-9522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |