Organization
PODOMEDIK LLC
Active
Other names
Carmen Sebastian-Novell
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARDO PEREZ-ESPINDOLA DPM (PHYSICIAN)
(856) 520-4513
Entity
Organization
Contact information
Practice address
2634 GRAND AVE STE 102A, WAUKEGAN, IL 60085-2459
(847) 249-3888
Mailing address
2634 GRAND AVE STE 102A, WAUKEGAN, IL 60085-2459
(847) 249-3888
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
911025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30-6095164
TAX ID
—
05
—
43241500
—
WI
Enumeration date
08/22/2006
Last updated
07/31/2012
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