Individual
PHILLIP DAVID NARCISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
19841 WOLF RD, MOKENA, IL 60448
(708) 479-0790
(708) 479-0792
Mailing address
19841 WOLF ROAD, MOKENA, IL 60448
(708) 479-0790
(708) 479-0792
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004628
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09904776
BCBS
IL
01
—
480035160
RAILROAD MEDICARE
IL
Enumeration date
03/27/2006
Last updated
12/23/2021
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