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NPI Code Detail

MEDICARE: PAMELA A EERNISSE DPM

MEDICARE:   PAMELA A EERNISSE  DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist16004918IL
2332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1427036151
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA A EERNISSE DPM
Provider Business Mailing Address
First Line : PO BOX 967
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477-0967
Country : US
Telephone Number : 312-337-2468
Fax Number : 312-337-6912
Provider Business Practice Location Address
First Line : 9050 W 81ST ST
Second Line :
City : JUSTICE
State : IL
Zip : 60458-1350
Country : US
Telephone Number : 708-594-3500
Fax Number : 708-594-3524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 02/14/2008

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Directions to “ PAMELA A EERNISSE DPM” Practice Location

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