Organization
FOOTWISE PODIATRY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY M. MARTINO D.P.M. (PRESIDENT)
(847) 837-1076
Entity
Organization
Contact information
Practice address
1324 KETTERING RD, MUNDELEIN, IL 60060-5364
(847) 837-1076
(847) 837-9228
Mailing address
1324 KETTERING RD, MUNDELEIN, IL 60060-5364
(847) 837-1076
(847) 837-9228
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-004178
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600-01724
BCBS OF ILLINOIS
IL
Enumeration date
06/12/2007
Last updated
01/01/2012
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