Organization Name: | DES PLAINES VALLEY FOOT CARE INC |
NPI Number: | 1073704672 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICHOLAS PARRILLI (OWNER) |
Mailing Address: | 123 E 9th St Suite 1b Lockport |
State: | IL US |
Postal Code: | 604413690 |
Phone Number: | 8158383668 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2007 |
NPI Last Update Date: | 01/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 016005231 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |