Healthcare Provider Details

I. General information

NPI: 1043914310
Provider Name (Legal Business Name): ANAS KACHLAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 W 95TH ST STE 306
OAK LAWN IL
60453-2572
US

IV. Provider business mailing address

4700 W 95TH ST STE 306
OAK LAWN IL
60453-2572
US

V. Phone/Fax

Practice location:
  • Phone: 708-424-3334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016006154
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: