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Organization
MCLEAN FOOT CLINIC,P.C.
Active
Organization
MCLEAN FOOT CLINIC,P.C.
Active
Other names
Harvard Foot Clinic,P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRSHAD AHMED SIDDIQUE D.P.M. (PRESIDENT)
(815) 943-7709
Entity
Organization
Contact information
Practice address
400 N DIVISION ST, HARVARD, IL 60033-3061
(815) 943-7709
(847) 931-7726
Mailing address
400 N DIVISION ST, HARVARD, IL 60033-3061
(815) 943-7709
(847) 931-7726
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005632037,004454016
BLUECROSS BLUESHIELD
IL
Enumeration date
05/22/2006
Last updated
12/08/2007
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