| NPI | 1881936649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE MARY-DANIELLE LEE Practice Administrator 224-227-6973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005367) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2018-06-20 |