| NPI | 1558788760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HERZOG Owner 708-557-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016003225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036059796) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2018-09-17 |