| NPI | 1851405716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LEANN HECK Physician 815-788-8680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016033688) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016004712) |
| 213E00000X Podiatrist (Licence: IL 016004823) | |
| 213E00000X Podiatrist (Licence: IL 016005064) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |