Dr Nicholas M Tabor III Dpm

NPI #1619146016 in Ottawa, Illinois

Provider Information

NPI Number: 1619146016
Entity Type: Organization
Organization Name: Dr Nicholas M Tabor III Dpm
Subpart: Yes (part of a larger organization)
Parent Organization: DR NICHOLAS M TABOR III DPM
Primary Specialty: Podiatrist
Enumeration Date: Feb 29, 2008
Last Updated: Mar 4, 2008

Practice Location

Address: 1703 POLARIS CIR
City: Ottawa
State: Illinois
ZIP Code: 61350-1683
Phone: (815) 433-5600

Authorized Official

Name: DR. NICHOLAS M TABOR III, DPM
Title: OWNER
Phone: (815) 224-3535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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