Organization
CATHERINE J MINNICK DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHERINE J MINNICK DPM (PODIATRIST/OWNER)
(773) 549-0323
Entity
Organization
Contact information
Practice address
561 W DIVERSEY PKWY, SUITE 212, CHICAGO, IL 60614-6068
(773) 549-0323
Mailing address
561 W DIVERSEY PKWY, SUITE 212, CHICAGO, IL 60614-6068
(773) 549-0323
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016003251
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060001266
BCBSIL
IL
05
—
016003251
—
IL
Enumeration date
10/09/2007
Last updated
02/01/2008
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