Individual
NICHOLAS ALEKSEI PODKOWIROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
950 W IL ROUTE 22 STE 105, LAKE ZURICH, IL 60047-3419
(847) 540-0234
(847) 540-0867
Mailing address
950 W IL ROUTE 22 STE 105, LAKE ZURICH, IL 60047-3419
(847) 540-0234
(847) 540-0867
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005829
IL
Other
Enumeration date
04/24/2017
Last updated
05/08/2019
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