| NPI | 1578733317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LAVELL President 773-525-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016003259) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-03-10 |