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General NPI Number Information
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NPI Number | 1104941574
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Entity Type | Organization
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Legal Business Name | FAMILY FOOT AND ANKLE CARE, P.C.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 726 S WEBER RD
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City | BOLINGBROOK
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State | IL
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Zip | 60490-5451
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Country | US
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Telephone | 630-739-6610
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Fax | 630-410-2482
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Provider Business Mailing Address
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Address Line | 227 CLUBHOUSE ST
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City | BOLINGBROOK
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State | IL
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Zip | 60490-2058
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Country | US
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Telephone | 630-739-6610
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Fax | 630-410-2482
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY E. DORAN
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Credential | DPM
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Telephone | 630-739-6610
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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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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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