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General NPI Number Information
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NPI Number | 1700348539
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Entity Type | Organization
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Legal Business Name | OSWEGO FOOT & ANKLE SPECIALISTS, PC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 1851 DOUGLAS RD
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City | MONTGOMERY
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State | IL
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Zip | 60538-2159
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Country | US
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Telephone | 630-892-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 DOUGLAS RD
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City | MONTGOMERY
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State | IL
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Zip | 60538-2159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PRAVEEN VOHRA
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Credential | DPM
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Telephone | 630-892-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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