Individual
DR. MARY M DISOMMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1100 LAKE ST, SUITE 248, OAK PARK, IL 60301-1015
(708) 383-5554
(708) 383-9321
Mailing address
1100 LAKE ST, SUITE 248, OAK PARK, IL 60301-1015
(708) 383-5554
(708) 383-9321
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160045851
—
IL
Enumeration date
12/12/2006
Last updated
07/08/2007
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