ERSTA PUTRA FERRYANTO

CHICAGO, IL
NPI1588243984
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy213E00000X Podiatrist
(Licence: IL  016006049)
Enumeration Date2021-04-05
Last Update Date2024-07-15
Business Address
ERSTA PUTRA FERRYANTO DPM
4805 N CLAREMONT AVE UNIT 1
CHICAGO, IL 60625-3791
Phone number: 678-549-6468
Mailing Address
ERSTA PUTRA FERRYANTO DPM
4805 N CLAREMONT AVE UNIT 1
CHICAGO, IL 60625-3791
Phone number: 678-549-6468
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