Healthcare Provider Details

I. General information

NPI: 1457740219
Provider Name (Legal Business Name): FOOT & ANKLE WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2015
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3385 N ARLINGTON HEIGHTS RD SUITE GH
ARLINGTON HEIGHTS IL
60004-7702
US

IV. Provider business mailing address

3385 N ARLINGTON HEIGHTS RD SUITE GH
ARLINGTON HEIGHTS IL
60004-7702
US

V. Phone/Fax

Practice location:
  • Phone: 847-419-3939
  • Fax: 847-749-3326
Mailing address:
  • Phone: 847-419-3939
  • Fax: 847-749-3326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE HALINSKI
Title or Position: PRESIDENT/CEO
Credential: DPM
Phone: 847-419-3939