| NPI | 1891840203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD JAY LEIB Owner 815-477-9221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004174) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |