Organization
MCDERMOTT PODIATRY OF JOLIET PC
Active
Other names
McDermott Podiatry of Joliet
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCDERMOTT DPM (OWNER)
(708) 403-1611
Entity
Organization
Contact information
Practice address
14532 JOHN HUMPHREY DR, ORLAND PARK, IL 60462-2640
(708) 403-1611
(708) 403-1650
Mailing address
14532 JOHN HUMPHREY DR, ORLAND PARK, IL 60462-2640
(708) 403-1611
(708) 403-1650
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004034
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004034
—
IL
01
—
IL4307
MEDICARE PTAN
IL
Enumeration date
12/08/2010
Last updated
12/15/2021
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