Provider Demographics
NPI:1174872717
Name:JOLIET FOOT CARE CENTER, PC
Entity type:Organization
Organization Name:JOLIET FOOT CARE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:OVERPECK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:815-730-8200
Mailing Address - Street 1:1100 ESSINGTON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8428
Mailing Address - Country:US
Mailing Address - Phone:815-730-5200
Mailing Address - Fax:815-730-8360
Practice Address - Street 1:1100 ESSINGTON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8428
Practice Address - Country:US
Practice Address - Phone:815-730-5200
Practice Address - Fax:815-730-8360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical