| NPI | 1730267659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL J MOORE Owner 708-479-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004283) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-11-02 |