MEDICARE: MIKLOS FOOT AND ANKLE SPECIALISTS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	016003168	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7061150001	OTHER	IL	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235384488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIKLOS FOOT AND ANKLE SPECIALISTS, PC

Provider Business Mailing Address
First Line	:	6634 W ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2408
Country	:	US
Telephone Number	:	773-586-5487
Fax Number	:	773-586-9523

Provider Business Practice Location Address
First Line	:	6634 W ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2408
Country	:	US
Telephone Number	:	773-586-5487
Fax Number	:	773-586-9523

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. ROBERT C MIKLOS
Credential	:	DPM
Telephone Number	:	773-586-5487

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	08/06/2015

Similar Medicare Providers

1275538811 — DR. ROBERT C MIKLOS DPM
Practice Location Address:

6634 W ARCHER AVE
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Practice Phone: 773-586-5487
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1720302474 — DR. JENNIFER MARIE MIKLOS DPM
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