| Organization Name: | DRS. MATTANA AND KWIECINSKI |
| NPI Number: | 1104998780 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY GAIL KWIECINSKI (PARTNER) |
| Mailing Address: | 250 Center Dr Suite 201 Vernon Hills |
| State: | IL US |
| Postal Code: | 600611582 |
| Phone Number: | 8478164711 |
| Fax Number: | 8472471158 |
| NPI Enumeration Date: | 11/15/2006 |
| NPI Last Update Date: | 03/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 016004013 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |