Provider Demographics
NPI:1801557632
Name:CAMPBELL PODIATRY SERVICES INCORPORATED
Entity type:Organization
Organization Name:CAMPBELL PODIATRY SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-445-9003
Mailing Address - Street 1:16 N YALE AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2339
Mailing Address - Country:US
Mailing Address - Phone:847-445-9003
Mailing Address - Fax:
Practice Address - Street 1:16 N YALE AVE
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2339
Practice Address - Country:US
Practice Address - Phone:847-445-9003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty