Provider Demographics
NPI:1558775031
Name:HARWOOD, AMANDA KATHERINE (DPM)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:KATHERINE
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:210 N HAMMES AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6688
Mailing Address - Country:US
Mailing Address - Phone:815-374-3668
Mailing Address - Fax:815-714-6208
Practice Address - Street 1:210 N HAMMES AVE
Practice Address - Street 2:STE 103
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6688
Practice Address - Country:US
Practice Address - Phone:815-374-3668
Practice Address - Fax:815-714-6208
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016.005753213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery