Individual
DR. BRYCE ANDREW PASCHOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-4254
Mailing address
20054 N 1000 EAST RD, CARLOCK, IL 61725-9568
(309) 242-3333
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005562
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
135000742
IL
213ES0131X
Foot Surgery Podiatrist
016005562
IL
Other
Enumeration date
06/28/2011
Last updated
11/21/2024
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