| NPI | 1518104322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD DUANE BRANN CEO 708-403-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016003703) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-08-18 |