Healthcare Provider Details

I. General information

NPI: 1043144942
Provider Name (Legal Business Name): FOOT FORWARD PODIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 SOUTHFIELD DR
VERNON HILLS IL
60061-3209
US

IV. Provider business mailing address

232 SOUTHFIELD DR
VERNON HILLS IL
60061-3209
US

V. Phone/Fax

Practice location:
  • Phone: 847-431-5033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GAREN AZIZI
Title or Position: OWNER
Credential: DPM
Phone: 847-431-5033