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
Phone: (708) 383-5554
Fax: (708) 383-9321
Website:
Authorized official contact:
Name: Disomma, Mary M Doctor of Podiatric Medicine (DPM)
Phone: (708) 383-5554
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285621235 | NPPES |
| Illinois | MEDICAID | 016004585 |
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