Organization
HMI FOOT AND ANKLE GROUP, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAYTHAM MANSOUR DPM, PHD (PODIATRIST)
(630) 656-3171
Entity
Organization
Contact information
Practice address
19255 EVERETT LN, SUITE B, MOKENA, IL 60448-8958
(630) 656-3171
(630) 657-0131
Mailing address
PO BOX 711, LOMBARD, IL 60148-0711
(630) 656-3171
(630) 657-0131
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005301
IL
Other
Enumeration date
11/19/2009
Last updated
11/11/2015
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