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Individual

DAVID G IACCINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
10661 S ROBERTS RD, SUITE 108, PALOS HILLS, IL 60465-1992
(708) 974-4380
(708) 974-4383
Mailing address
10661 S ROBERTS ROAD, SUITE 108, PALOS HILLS, IL 60465-1992
(708) 974-4380
(708) 974-4383

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003882
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480006875
RAILROAD MCR
01
60001580
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/13/2006
Last updated
10/30/2008
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