| NPI | 1891965786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY L. JULIUS-BUCKLEY Managed Care Director 773-233-0590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-07-03 |