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NPI Code Detail

MEDICARE: JOSEPH SKERTICH

MEDICARE:   JOSEPH  SKERTICH
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
1222Z00000XOrthotist2130000070IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558373175
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH SKERTICH
Provider Business Mailing Address
First Line : 3958 ROSE AVE
Second Line :
City : WESTERN SPRINGS
State : IL
Zip : 60558-1032
Country : US
Telephone Number : 708-246-9249
Fax Number :
Provider Business Practice Location Address
First Line : 3958 ROSE AVE
Second Line :
City : WESTERN SPRINGS
State : IL
Zip : 60558-1032
Country : US
Telephone Number : 708-246-9249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 07/08/2007

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Directions to “ JOSEPH SKERTICH ” Practice Location

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