Organization
PAM EERNISSE DPM SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA ANN EERNISSE DPM (OWNER)
(312) 701-0770
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE, SUITE 720, CHICAGO, IL 60602-3402
(312) 701-0770
(312) 701-0705
Mailing address
9050 W 81ST ST, JUSTICE, IL 60458-1350
(708) 594-3500
(708) 594-3526
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004918
IL
332B00000X
Durable Medical Equipment & Medical Supplies
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Other
Enumeration date
01/20/2009
Last updated
12/06/2012
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