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 |