Healthcare Provider Details

I. General information

NPI: 1477576189
Provider Name (Legal Business Name): POPLAR CREEK FOOT & ANKLE CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W. HIGGINS RD. SUITE 910
HOFFMAN ESTATES IL
60169
US

IV. Provider business mailing address

2500 W. HIGGINS RD. SUITE 910
HOFFMAN ESTATES IL
60169
US

V. Phone/Fax

Practice location:
  • Phone: 847-882-0456
  • Fax: 847-882-0465
Mailing address:
  • Phone: 847-882-0456
  • Fax: 847-882-0465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DEBRA A. LEVINTHAL
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 847-882-0456