| NPI | 1922204106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORTUNEE MASSUDA Medical Director & CEO 773-233-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 211D00000X Assistant, Podiatric |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213EP0504X Podiatrist, Public Medicine | |
| 213ES0131X | |
| 213ER0200X Podiatrist, Radiology | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2025-09-11 |