| NPI | 1700578150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER J BUSSER Authorized Official 847-910-1082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-05-24 |