Individual
DR. DARRELL R LATVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1108 S KEDZIE AVE, CHICAGO, IL 60612-3935
(773) 722-2712
Mailing address
3537 PAYSPHERE CIR, CHICAGO, IL 60674-0035
(708) 786-2900
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
016-003092
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016-003092-3
—
IL
Enumeration date
08/31/2005
Last updated
02/22/2012
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