Healthcare Provider Details

I. General information

NPI: 1891828075
Provider Name (Legal Business Name): MIDWEST FOOT & ANKLE CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 W HIGGINS RD STE 101
HOFFMAN ESTATES IL
60169-2432
US

IV. Provider business mailing address

2260 W HIGGINS RD STE 101
HOFFMAN ESTATES IL
60169-2432
US

V. Phone/Fax

Practice location:
  • Phone: 847-398-8637
  • Fax: 855-850-7854
Mailing address:
  • Phone: 847-398-8637
  • Fax: 855-850-7854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016004842
License Number StateIL

VIII. Authorized Official

Name: S. KHALID HUSAIN
Title or Position: PRESIDENT
Credential: DPM
Phone: 847-398-8637