Healthcare Provider Details

I. General information

NPI: 1477713212
Provider Name (Legal Business Name): PREMIER FOOT & ANKLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 N ARLINGTON HEIGHTS RD SUITE 170
BUFFALO GROVE IL
60089-1783
US

IV. Provider business mailing address

165 N ARLINGTON HEIGHTS RD SUITE 170
BUFFALO GROVE IL
60089-1783
US

V. Phone/Fax

Practice location:
  • Phone: 847-419-3939
  • Fax: 224-676-0448
Mailing address:
  • Phone: 847-419-3939
  • Fax: 224-676-0448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016004807
License Number StateIL

VIII. Authorized Official

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