Disomma Foot & Ankle Clinic Pc

LBN: Disomma Foot & Ankle Clinic Pc
Disomma Foot & Ankle Clinic Pc is an health care organization with primary practice located at 1100 Lake St Ste 248, Oak Park IL 60301-1015. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Disomma Foot & Ankle Clinic Pc can be contacted via phone (708) 383-5554, or through Disomma, Mary M via phone (708) 383-5554.

Contact Information

Primary practice address
1100 Lake St Ste 248 Oak Park IL 60301-1015
Fax: (708) 383-9321
Website:
Authorized official contact:
Name: Disomma, Mary M Doctor of Podiatric Medicine (DPM)

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 060007223 Illinois
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004585 Illinois

Profile Details

NPI number 1285621235
LBN Legal business name Disomma Foot & Ankle Clinic Pc
DBA Doing business as
Authorized official Disomma, Mary M Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2005
Last updated Jul 17th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285621235 NPPES
Illinois MEDICAID 016004585

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