Organization
ADVANCED FOOT CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HAZEL HERNANDEZ DPM (PODIATRIST)
(773) 472-1882
Entity
Organization
Contact information
Practice address
2834 N LINCOLN AVE, CHICAGO, IL 60657-4202
(773) 472-1882
(773) 472-1891
Mailing address
PO BOX 578246, CHICAGO, IL 60657-8246
(773) 472-1882
(773) 472-1891
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621292
BCBS
IL
Enumeration date
11/06/2006
Last updated
08/22/2020
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