| NPI | 1871820381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY TODD HORAK President 708-799-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: IL 016-004735) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric (Licence: IL 016-004714) |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2009-11-05 |