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General NPI Number Information
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NPI Number | 1003498478
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Entity Type | Organization
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Legal Business Name | NORTHERN ILLINOIS FOOT & ANKLE SPECIALISTS, LTD
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 908 N ELM ST STE 310
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City | HINSDALE
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State | IL
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Zip | 60521-3625
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Country | US
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Telephone | 847-638-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 750 E TERRA COTTA AVE STE C
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-3621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK ALLEN MCENEANEY
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Credential |
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Telephone | 847-639-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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