Organization
AUDEY NASSER PODIATRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDEY NASSER DPM (PODIATRIST)
(313) 969-9775
Entity
Organization
Contact information
Practice address
731 S IL ROUTE 21 STE 140, GURNEE, IL 60031-3812
(847) 295-9300
(847) 295-9607
Mailing address
731 S IL ROUTE 21 STE 140, GURNEE, IL 60031-3812
(313) 969-9775
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002505
MI
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI9259001
MEDICARE PTAN
MI
Enumeration date
12/01/2015
Last updated
01/20/2023
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