Healthcare Provider Details

I. General information

NPI: 1588008692
Provider Name (Legal Business Name): PODIATRY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2013
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 OLD CHECKER RD
BUFFALO GROVE IL
60089-1689
US

IV. Provider business mailing address

832 OLD CHECKER RD
BUFFALO GROVE IL
60089-1689
US

V. Phone/Fax

Practice location:
  • Phone: 847-790-4541
  • Fax: 847-701-5586
Mailing address:
  • Phone: 847-790-4541
  • Fax: 847-701-5586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. HONG SUK YOON
Title or Position: DIRECTOR
Credential: DPM
Phone: 847-790-4541