Asg Onsite Podiatry of Wi 1 Sc

NPI #1982957528 in Chicago, Illinois

Provider Information

NPI Number: 1982957528
Entity Type: Organization
Organization Name: Asg Onsite Podiatry of Wi 1 Sc
Primary Specialty: Podiatrist
Enumeration Date: Oct 19, 2012
Last Updated: Oct 19, 2012

Practice Location

Address: 10 S RIVERSIDE PLZ
Address 2: STE 19 EAST
City: Chicago
State: Illinois
ZIP Code: 60606-3728
Phone: (773) 770-0140

Authorized Official

Name: YEV GRAY, DPM
Title: OWNER
Phone: (773) 770-0140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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