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General NPI Number Information
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NPI Number | 1104083369
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Entity Type | Organization
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Legal Business Name | MODERN FOOT & ANKLE CENTERS, PLLC
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 600 S DOBSON RD STE E40
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City | CHANDLER
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State | AZ
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Zip | 85224-5693
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Country | US
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Telephone | 480-909-3700
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Fax | 877-839-9972
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Provider Business Mailing Address
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Address Line | 2680 S VAL VISTA DR STE 177
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City | GILBERT
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State | AZ
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Zip | 85295-1674
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Country | US
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Telephone | 480-909-3700
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Fax | 877-839-9972
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | ILONA EVZEN SIGLOVA
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Credential |
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Telephone | 480-909-3700
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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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