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General NPI Number Information
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NPI Number | 1023002896
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Entity Type | Organization
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Legal Business Name | AFFILIATED PODIATRISTS, LTD.
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 6445 N CENTRAL AVE STE 301
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City | CHICAGO
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State | IL
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Zip | 60646-2901
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Country | US
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Telephone | 773-202-8800
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Fax | 773-631-2461
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Provider Business Mailing Address
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Address Line | 6445 N CENTRAL AVE STE 301
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City | CHICAGO
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State | IL
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Zip | 60646-2901
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Country | US
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Telephone | 773-202-8800
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Fax | 773-631-2461
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON MICHAEL KALK
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Credential | DPM
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Telephone | 773-202-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 060-001195
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 060-001195
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License Number State | IL
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