Disomma Foot & Ankle Clinic Pc

NPI 1285621235 - Podiatrist - 213E00000X

NPI Details
NPI 1285621235
Enumeration Date 10/04/2005
Last Updated 07/17/2013
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name MARY M MARY
Position PRESIDENT
Phone (708) 383-5554
Fax (708) 383-9321
Practice Location
1100 LAKE ST
STE 248
OAK PARK IL, 60301-1015, US
Phone (708) 383-5554
Fax (708) 383-9321
Business Location
1100 LAKE ST
STE 248
OAK PARK IL, 60301-1015, US
Phone (708) 383-5554
Fax (708) 383-9321
Toxanomy
Taxonomy Code 213E00000X
License State Illinois
License Number 016004585
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According to our database, Disomma Foot & Ankle Clinic Pc NPI is 1285621235, taxonomy code is 213E00000X and license number is 016004585, license state is located at Illinois. Disomma Foot & Ankle Clinic Pc physically located at 1100 Lake St, Oak Park IL, 60301-1015. NPI Number 1033115704 has the healthcare provider type.

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1285621235 NPI number is provided on an as is basis without warranty of any kind. 1285621235 is maintained by the National Plan & Provider Enumeration System. The contents of Disomma Foot & Ankle Clinic Pc are for informational purposes only.