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General NPI Number Information
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NPI Number | 1104558311
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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 | 06/27/2022
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 5600 W ADDISON ST # LL
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City | CHICAGO
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State | IL
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Zip | 60634-4401
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Country | US
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Telephone | 847-639-5800
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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 A
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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 | 847-639-5800
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | PATRICK ALLEN MCENEANEY
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Credential | DPM
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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 | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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