Latva, Darrell R

Latva, Darrell R is an individual health care provider with primary practice located at 1108 S Kedzie Ave , Chicago IL 60612-3935. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Latva, Darrell R can be contacted via phone (773) 722-2712.

Contact Information

Primary practice address
1108 S Kedzie Ave Chicago IL 60612-3935
Phone: (773) 722-2712
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 016-003092 Illinois

Profile Details

NPI number 1902890395
LBN Legal business name Latva, Darrell R
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Feb 22nd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902890395 NPPES
Illinois MEDICAID 016-003092-3

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