Individual
MICHAEL ANDREW WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
10528 S EWING AVE, CHICAGO, IL 60617-6219
(773) 375-0791
(773) 734-2723
Mailing address
PO BOX 49, LANSING, IL 60438-0049
(708) 418-5551
(708) 418-5590
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004728
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40022238
RR MEDICARE
IL
Enumeration date
06/12/2006
Last updated
10/05/2011
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