Organization
AFFILIATED PODIATRISTS OF ILLINOIS LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB W GREENSPAN D.P.M. (OWNER)
(847) 562-9864
Entity
Organization
Contact information
Practice address
350 OAK KNOLL TER, NORTHBROOK, IL 60062-1048
(847) 562-9864
(847) 562-9865
Mailing address
PO BOX 220, MATTESON, IL 60443-0220
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-003364
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002215448
BLUE SHIELD
IL
05
—
016003364
—
IL
Enumeration date
12/27/2006
Last updated
11/25/2009
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