Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 213000217 | IL |
N | 222Z00000X | Podiatrist | 213000217 | IL |
Y | 224P00000X | Prosthetist | 211000293 | IL |
NPI | 1306065958 |
---|---|
Provider Name | Mr. Erik James Lindholm |
First Address | Joliet, IL 60435-3962 |
Second Address | Joliet, IL 60435-3962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 20/03/2016 |