| Dr Brian C Wittmayer, DPM | |
|
401 E. 162nd St, Suite 101, South Holland, IL 60473-2236 | |
| (708) 596-3757 | |
| (708) 596-3779 |
| Full Name | Dr Brian C Wittmayer |
|---|---|
| Gender | Male |
| Speciality | Podiatrist |
| Location | 401 E. 162nd St, South Holland, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174671333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 016-005326 (Illinois) | Primary |
| Provider Name | Performance Foot And Ankle Center, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1750397428 PECOS PAC ID: 7517850902 Enrollment ID: O20040209000172 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brian C Wittmayer, DPM 401 E. 162nd Street, Suite 101, South Holland, IL 60473 Ph: (708) 596-3757 | Dr Brian C Wittmayer, DPM 401 E. 162nd St, Suite 101, South Holland, IL 60473-2236 Ph: (708) 596-3757 |
Dr. Dale Steven Brink, DPM, FACFAS Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 E 162nd St Ste 101, South Holland, IL 60473 Phone: 708-596-3757 Fax: 708-596-3779 | |
Dr. Timothy J Krygsheld, DPM, FACFAS Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 E 162nd St Ste 101, South Holland, IL 60473 Phone: 708-596-3757 Fax: 708-596-3779 | |
Vivek Patel, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 E 162nd St, Suite 101, South Holland, IL 60473 Phone: 708-596-3757 |