| NPI | 1861424368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A RYERSON Podiatrist 773-237-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016003397) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: IL 016003397) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-08-22 |