Organization
CORTESE FOOT AND ANKLE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL JOHN CORTESE D.P.M (OWNER)
(309) 452-3000
Entity
Organization
Contact information
Practice address
1607 VISA DR STE 5B, NORMAL, IL 61761-6160
(309) 452-3000
(309) 452-3668
Mailing address
1607 VISA DR STE 5B, NORMAL, IL 61761-6160
(309) 452-3000
(309) 452-3668
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
060-008632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016002598
—
IL
Enumeration date
08/12/2006
Last updated
01/07/2013
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