BRECK TIERNAN PC NPI 1730354382

NPI Information

NPI: 1730354382
Provider Name: BRECK TIERNAN PC

Doing Business As: ADVANCED FOOT AND ANKLE CENTER OF JOLIET

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
350 HOUBOLT RD
SUITE 104
JOLIET, IL
ZIP 60431
Phone: (815) 553-0990
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BRECK TIERNAN PC is a foot and ankle surgery podiatrist in Joliet, IL. BRECK TIERNAN PC NPI is 1730354382. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advanced Foot And Ankle Center Of Joliet.

The provider's business location address is:

350 HOUBOLT RD
SUITE 104
JOLIET, IL
ZIP 60431-305
Phone: (815) 553-0990
Fax: (815) 553-0991

The provider's authorized official is Breck Michael Tiernan .
The authorized official title is Owner and has the following contact phone number (815) 553-0990.

The enumeration date for this NPI number is 4/24/2008 and was last updated on 10/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	016005321	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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