| NPI | 1639507163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY S KRUSE Owner 312-280-7886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213EP0504X Podiatrist, Public Medicine |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 213ES0131X Podiatrist, Foot Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2023-05-01 |