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General NPI Number Information
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NPI Number | 1740941343
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Entity Type | Organization
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Legal Business Name | ELIZABETH UNANUE LLC
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 4215 KIRCHOFF RD
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-2005
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Country | US
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Telephone | 224-430-6773
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Fax |
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Provider Business Mailing Address
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Address Line | 808 S CUMBERLAND AVE
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City | PARK RIDGE
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State | IL
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Zip | 60068-4635
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Country | US
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Telephone | 224-430-6773
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH UNANUE
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Credential | DPM
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Telephone | 224-430-6773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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