| NPI | 1801060561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER JOSEPH JACOBSEN President 773-561-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004485) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2010-11-09 |