Healthcare Provider Details

I. General information

NPI: 1427331347
Provider Name (Legal Business Name): JASON M. KALK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6445 N CENTRAL AVE FL 1
CHICAGO IL
60646-2901
US

IV. Provider business mailing address

6445 N CENTRAL AVE FL 1
CHICAGO IL
60646-2901
US

V. Phone/Fax

Practice location:
  • Phone: 773-202-8800
  • Fax:
Mailing address:
  • Phone: 773-202-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016005508
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number016005508
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: