NPI 1619255452 · live from the CMS NPI Registry
Advanced Podiatry Clinics Ltd
Podiatrist in Melrose Park, IL. National Provider Identifier 1619255452, active.
NPI record
| NPI | 1619255452 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 1835 N 19th Ave, Suite 102, Melrose Park, IL 60160 |
| Practice phone | 708-450-0705 |
| Enumerated | July 27, 2011 |
| Last updated | December 10, 2013 |
| Authorized official | Igor Dukarevich, Medical Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 016005409 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.