| NPI | 1518210673 |
|---|---|
| Doing Business As | ADVANCED FOOT & ANKLE CENTERS OF ILLINOIS |
| Entity Type | Organization |
| Authorized Contact | BRECK M. TIERNAN Medical Director 815-553-0990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |