Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 1 | IL |
Y | 213ES0103X | Foot & Ankle Surgery | 016.005959 | IL |
N | 213ES0103X | Foot & Ankle Surgery | 135.000999 | IL |
NPI | 1528563483 |
---|---|
Provider Name | Dr. Christopher Cklamovski |
First Address | Willow Springs, IL 60480-1010 |
Second Address | Maywood, IL 60153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2018 |
Last Update Date | 21/10/2021 |