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General NPI Number Information
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NPI Number | 1063381952
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Entity Type | Organization
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Legal Business Name | SOUTHWEST FOOT ANKLE, LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 6253 W 95TH ST STE 1A
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City | OAK LAWN
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State | IL
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Zip | 60453-2788
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Country | US
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Telephone | 630-401-8286
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Fax | 630-401-8648
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Provider Business Mailing Address
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Address Line | 6253 W 95TH ST STE 1A
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City | OAK LAWN
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State | IL
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Zip | 60453-2788
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Country | US
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Telephone | 630-401-8286
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Fax | 630-401-8648
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Authorized Official
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Title or Position | OWNER
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Name | SHAYAN ALAMGIR
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Credential |
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Telephone | 630-401-8248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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