Healthcare Provider Details

I. General information

NPI: 1699202663
Provider Name (Legal Business Name): THE FOOT AND ANKLE CLINICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10176 W 400 N STE B
MICHIGAN CITY IN
46360-9009
US

IV. Provider business mailing address

9340 LOCHWOOD PL
TINLEY PARK IL
60487-4797
US

V. Phone/Fax

Practice location:
  • Phone: 219-809-9839
  • Fax: 219-809-9841
Mailing address:
  • Phone: 708-250-3869
  • Fax: 219-809-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. MURAD ABDEL-QADER
Title or Position: OWNER
Credential: DPM
Phone: 708-250-3869