Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016005499 | IL |
NPI | 1093153124 |
---|---|
Provider Name | Sarah Kaye Mahowald |
First Address | Oak Lawn, IL 60453-1836 |
Second Address | Oak Lawn, IL 60453-1836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2013 |
Last Update Date | 11/06/2013 |