Individual
ERSTA PUTRA FERRYANTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2200 WAUKEGAN RD STE FGH, GLENVIEW, IL 60025-1759
(847) 558-7670
(888) 202-3110
Mailing address
2200 WAUKEGAN RD STE FGH, GLENVIEW, IL 60025-1759
(847) 558-7670
(888) 202-3110
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016006049
IL
Other
Enumeration date
04/05/2021
Last updated
02/23/2026
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