Organization
FOOT AND ANKLE PODIATRIC AND ORTHOPEDIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIF MATOUK (PRESIDENT)
(815) 312-3885
Entity
Organization
Contact information
Practice address
11450 TEA TREE LN, FRANKFORT, IL 60423-5102
(815) 312-3885
Mailing address
11450 TEA TREE LN, FRANKFORT, IL 60423-5102
(815) 312-3885
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-005096
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005096
—
IL
Enumeration date
05/23/2013
Last updated
05/23/2013
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