Healthcare Provider Details

I. General information

NPI: 1912549650
Provider Name (Legal Business Name): CENTERS FOR FOOT AND ANKLE SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

654 W VETERANS PKWY STE C
YORKVILLE IL
60560-2510
US

IV. Provider business mailing address

654 W VETERANS PKWY STE C
YORKVILLE IL
60560-2510
US

V. Phone/Fax

Practice location:
  • Phone: 630-553-9300
  • Fax: 630-553-9306
Mailing address:
  • Phone: 630-553-9300
  • Fax: 630-553-9306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: THOMAS RAPPETTE
Title or Position: AUTHORIZED OFFICIAL
Credential: DPM
Phone: 630-553-9300