Organization
MCLEAN FOOT CLINIC,P.C.
Active
Other names
Harvard Foot Clinic,P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRSHAD AHMED SIDDIQUE D.P.M. (PRESIDENT)
(815) 943-7709
Entity
Organization
Contact information
Practice address
400 N DIVISION ST, HARVARD, IL 60033-3061
(815) 943-7709
(847) 931-7726
Mailing address
400 N DIVISION ST, HARVARD, IL 60033-3061
(815) 943-7709
(847) 931-7726
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005632037,004454016
BLUECROSS BLUESHIELD
IL
Enumeration date
05/22/2006
Last updated
12/08/2007
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