| NPI | 1831336379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ANN EERNISSE Owner 312-701-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004918) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2012-12-06 |