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Organization

DENISE J PETENZI, DPM, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DENISE PETENZI DPM (OWNER)
(312) 505-0156
Entity
Organization

Contact information

Practice address
2644 N WAYNE AVE APT C, CHICAGO, IL 60614-6783
(312) 505-0156
Mailing address
2644 N WAYNE AVE, UNIT C, CHICAGO, IL 60614-1222
(312) 505-0156
(773) 529-3911

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005107
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016005107
IL
Enumeration date
09/15/2016
Last updated
12/28/2023
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