Healthcare Provider Details
I. General information
NPI: 1720341035
Provider Name (Legal Business Name): ANNA M GARBULA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/21/2012
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 E SAINT CHARLES RD STE 100
LOMBARD IL
60148-2302
US
IV. Provider business mailing address
PO BOX 848195
LOS ANGELES CA
90084-8195
US
V. Phone/Fax
- Phone: 630-206-3837
- Fax: 224-220-9743
- Phone: 847-390-7666
- Fax: 224-220-9743
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 016005581 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 016005581 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: