Organization
ADVANCED FOOT CARE OF PALATINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DAVID SURAN D.P.M. (PRESIDENT)
(847) 358-7005
Entity
Organization
Contact information
Practice address
711 W DUNDEE RD, PALATINE, IL 60074-0715
(847) 358-7005
(847) 358-7065
Mailing address
PO BOX 965, PALATINE, IL 60078-0965
(847) 358-7005
(847) 358-7065
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60001608
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
06/25/2007
Last updated
10/26/2007
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