NPI 1881745388 · live from the CMS NPI Registry
Advanced Podiatry
Podiatrist, Foot & Ankle Surgery in Summit, IL. National Provider Identifier 1881745388, active.
NPI record
| NPI | 1881745388 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 7355 Archer Ave, Suite D, Summit, IL 60501 |
| Practice phone | 773-229-8200 |
| Enumerated | January 13, 2007 |
| Last updated | December 2, 2009 |
| Authorized official | Mark Gagnon, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.