| NPI | 1881026185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM A EERNISSE Stockholder 312-701-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004918) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2015-08-26 |