Organization
CHICAGO PODIATRY SURGICORE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY COWAN D.P.M. (PRESIDENT)
(773) 978-1244
Entity
Organization
Contact information
Practice address
1518 E 87TH ST, CHICAGO, IL 60619-6525
(773) 978-1244
(773) 978-4606
Mailing address
1518 E 87TH ST, CHICAGO, IL 60619-6525
(773) 978-1244
(773) 978-4606
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2006
Last updated
10/29/2007
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