Organization
POTACH-MOON PODIATRY GROUP, LLC
Active
Other names
PM Podiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS E MENDOZA DPM (PRESIDENT)
(708) 780-8661
Entity
Organization
Contact information
Practice address
5610 W CERMAK RD UNIT 2, CICERO, IL 60804-2219
(708) 780-8661
(708) 780-9537
Mailing address
5610 W CERMAK RD UNIT 2, CICERO, IL 60804-2219
(708) 780-8661
(708) 780-9537
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
07/16/2015
Last updated
01/05/2019
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