| NPI | 1841308343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN R HACKEL President 708-344-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004903) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 5047180002) |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2012-01-19 |