Provider Demographics
NPI:1588008692
Name:PODIATRY CARE, INC
Entity Type:Organization
Organization Name:PODIATRY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HONG
Authorized Official - Middle Name:SUK
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-790-4541
Mailing Address - Street 1:832 OLD CHECKER RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1689
Mailing Address - Country:US
Mailing Address - Phone:847-790-4541
Mailing Address - Fax:847-701-5586
Practice Address - Street 1:832 OLD CHECKER RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1689
Practice Address - Country:US
Practice Address - Phone:847-790-4541
Practice Address - Fax:847-701-5586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty