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General NPI Number Information
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NPI Number | 1710308440
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Entity Type | Organization
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Legal Business Name | CHICAGO PODIATRIC SURGEONS PC
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Dates
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Enumeration Date | 12/24/2013
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Last Update Date | 12/24/2013
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Provider Practice Location Address
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Address Line | 6 E SAINT CHARLES RD
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City | LOMBARD
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State | IL
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Zip | 60148-2302
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Country | US
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Telephone | 630-495-1240
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Fax |
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Provider Business Mailing Address
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Address Line | 467 W ERIE ST
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City | CHICAGO
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State | IL
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Zip | 60654-5704
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Country | US
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Telephone | 312-337-9900
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. THOMAS CARR
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Credential |
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Telephone | 312-337-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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