Individual
GEORGE L ENRIQUEZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2101 WAUKEGAN RD STE 203, BANNOCKBURN, IL 60015-1836
(847) 390-7666
(847) 390-9345
Mailing address
1660 FEEHANVILLE DR STE 450, MT PROSPECT, IL 60056-6023
(847) 390-7666
(847) 390-9345
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003880
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
016003880
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016003880
—
IL
Enumeration date
11/30/2006
Last updated
12/30/2021
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