Individual
LUIS E MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5610 W CERMAK RD, CICERO, IL 60804
(708) 780-8661
(708) 231-9818
Mailing address
5610 W CERMAK RD, CICERO, IL 60804
(708) 780-8661
(708) 231-9818
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004474
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004474
—
IL
Enumeration date
06/09/2006
Last updated
03/15/2023
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