Organization
WILLOW FALLS PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN WHITFIELD DPM (PODIATRIST)
(603) 390-9810
Entity
Organization
Contact information
Practice address
16151 WEBER RD, SUITE 107, CREST HILL, IL 60403-0863
(815) 838-0282
(815) 230-0036
Mailing address
1560 SUNCREST LN, BOLINGBROOK, IL 60490-3278
(815) 838-0282
(815) 230-0036
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016003971
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060001542
BLUE CROSS BLUE SHIELD
IL
05
—
016003971
—
IL
Enumeration date
09/27/2010
Last updated
09/27/2010
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