Organization
MERCADO FOOT AND ANKLE CLINICS SOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA M. MERCADO-CIESSAU DPM (PODIATRIST/OWNER)
(708) 484-3599
Entity
Organization
Contact information
Practice address
3245 GROVE AVE, SUITE 106, BERWYN, IL 60402-3474
(708) 484-3599
(708) 749-0727
Mailing address
3245 GROVE AVE, SUITE 106, BERWYN, IL 60402-3474
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004482
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004482
—
IL
Enumeration date
07/13/2005
Last updated
01/28/2010
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