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General NPI Number Information
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NPI Number | 1811171630
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Entity Type | Organization
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Legal Business Name | BRIAN CHIARAMONTE FOOT AND ANKLE CENTER OF BRIDGEPORT
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 3303 S HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60608-6705
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Country | US
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Telephone | 773-579-1440
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Fax | 773-579-0227
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Provider Business Mailing Address
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Address Line | 3303 S HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60608-6705
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Country | US
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Telephone | 773-579-1440
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Fax | 773-579-0227
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN J CHIARAMONTE
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Credential | DPM
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Telephone | 773-579-1440
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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 | 016-004502
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License Number State | IL
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