Healthcare Provider Details

I. General information

NPI: 1871863662
Provider Name (Legal Business Name): NEXT STEP FOOT & ANKLE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 HAMACHER ST SUITE 202
WATERLOO IL
62298-1592
US

IV. Provider business mailing address

3505 COLLEGE AVE SUITE B
ALTON IL
62002-5065
US

V. Phone/Fax

Practice location:
  • Phone: 618-939-5979
  • Fax:
Mailing address:
  • Phone: 618-462-9695
  • Fax: 618-462-9651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDSAY BARTH
Title or Position: PRESIDENT
Credential: DPM
Phone: 618-462-9695