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Podomedik Llc
Foot & Ankle Surgery Podiatrist in Waukegan, Illinois
NPI 1215043310

Podomedik Llc is a Foot & Ankle Surgery Podiatrist based in Waukegan, IL and is specialized in Foot & Ankle Surgery. Podomedik Llc practices in Waukegan, IL. The NPI Number for Podomedik Llc is 1215043310 and holds a License No. 911025 (Illinois).

The current practice location address for Podomedik Llc is 2634 Grand Ave Ste 102A, Waukegan, IL and can be reached out via phone at 847-249-3888.

Location: 2634 Grand Ave Ste 102A, Waukegan, IL, 60085-2459
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215043310
Provider Name
Podomedik Llc
Credential
Provider Entity Type
Organization
Address
2634 Grand Ave Ste 102A, Waukegan, IL, 60085-2459
Phone Number
847-249-3888
Fax Number
Provider Enumeration Date
08/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
43241500 05 WI
30-6095164 01 TAX ID
institution
Provider Business Practice Location Address Details
Address
2634 Grand Ave Ste 102A
City
Waukegan
State
Illinois
Zip
60085-2459
Phone Number
847-249-3888
Fax Number
person
Provider Business Mailing Address Details
Address
2634 Grand Ave Ste 102A
City
Waukegan
State
Illinois
Zip
60085-2459
Phone Number
847-249-3888
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
911025 (Wisconsin)
Definition
Definition to come...
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