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Individual

DR. ERNEST V. ISADORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2210 DEAN STREET, SUITE C, ST CHARLES, IL 60175
(630) 377-5001
(630) 377-5021
Mailing address
2210 DEAN STREET, SUITE C, ST CHARLES, IL 60175
(630) 377-5001
(630) 377-5021

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-002699
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004515235
BCBS STC
IL
01
363432665
TAX ID STC
IL
01
480028367
RR MEDICARE
IL
01
60100844
BCBS-AUR
IL
Enumeration date
08/03/2006
Last updated
12/03/2008
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