Healthcare Provider Details

I. General information

NPI: 1699961011
Provider Name (Legal Business Name): BAILEY FOOT & ANKLE SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13246 S ROUTE 59 SUITE 104
PLAINFIELD IL
60585-9800
US

IV. Provider business mailing address

13246 S ROUTE 59 SUITE 104
PLAINFIELD IL
60585-9800
US

V. Phone/Fax

Practice location:
  • Phone: 815-230-2255
  • Fax: 815-230-4925
Mailing address:
  • Phone: 815-230-2255
  • Fax: 815-230-4925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0009932532
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerBLUE CROSS BLUE SHIELD
# 2
IdentifierDF7342
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerRAILROAD MEDICARE

VIII. Authorized Official

Name: CHRISTOPHER BAILEY
Title or Position: OWNER
Credential: DPM
Phone: 815-230-2255