Organization
PERFORMANCE PODIATRY PARTNERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUPNA REILLY DPM (PHYSICIAN)
(508) 259-8466
Entity
Organization
Contact information
Practice address
4805 N CLAREMONT AVE, COMMERCIAL UNIT 1, CHICAGO, IL 60625
(312) 579-3150
Mailing address
2120 N WINCHESTER AVE, CHICAGO, IL 60614-3915
(508) 259-8466
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
—
—
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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