Organization
MICHIGAN AVE PODIATRY LLC 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAM A EERNISSE DPM (STOCKHOLDER)
(312) 701-0770
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE, SUITE 720, CHICAGO, IL 60602-3809
(312) 701-0770
(312) 701-0705
Mailing address
30 N MICHIGAN AVE, SUITE 720, CHICAGO, IL 60602-3809
(312) 701-0770
(312) 701-0705
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004918
IL
Other
Enumeration date
08/08/2013
Last updated
08/26/2015
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