| Organization Name: | CHICAGO PODIATRIC SURGEONS P.C. |
| NPI Number: | 1053747352 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS CARR (PRACTICE OWNER) |
| Mailing Address: | 16325 Harlem Ave Suite 100 Tinley Park |
| State: | IL US |
| Postal Code: | 604772509 |
| Phone Number: | 3123379900 |
| Fax Number: | 3123379902 |
| NPI Enumeration Date: | 09/18/2013 |
| NPI Last Update Date: | 09/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Podiatric |
| Taxonomy Definition: | |