Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016003261 | IL |
Y | 222Z00000X | Podiatrist | 016003261 | IL |
NPI | 1063476828 |
---|---|
Provider Name | Steven French |
First Address | Orland Park, IL 60462-4333 |
Second Address | Orland Park, IL 60462-4333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016003261 | (05) | IL |
T37804 | (02) | IL |