| NPI | 1548369192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA S PAUL Cpc / Medical Biller 815-765-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016002717) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-08-26 |