Healthcare Provider Details

I. General information

NPI: 1023002896
Provider Name (Legal Business Name): AFFILIATED PODIATRISTS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 09/07/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6445 N CENTRAL AVE STE 301
CHICAGO IL
60646-2901
US

IV. Provider business mailing address

6445 N CENTRAL AVE STE 301
CHICAGO IL
60646-2901
US

V. Phone/Fax

Practice location:
  • Phone: 773-202-8800
  • Fax: 773-631-2461
Mailing address:
  • Phone: 773-202-8800
  • Fax: 773-631-2461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number060-001195
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number060-001195
License Number StateIL

VIII. Authorized Official

Name: DR. JASON MICHAEL KALK
Title or Position: PRESIDENT
Credential: DPM
Phone: 773-202-8800