Healthcare Provider Details

I. General information

NPI: 1992119739
Provider Name (Legal Business Name): ANKLE N FOOT CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S JEFFERSON ST
CHICAGO IL
60661-5607
US

IV. Provider business mailing address

225 S JEFFERSON ST
CHICAGO IL
60661-5607
US

V. Phone/Fax

Practice location:
  • Phone: 312-612-5000
  • Fax: 888-895-7225
Mailing address:
  • Phone: 312-612-5000
  • Fax: 888-895-7225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. GEORGE TSATSOS
Title or Position: DIRECTOR
Credential: D.P.M.
Phone: 312-612-5000