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General NPI Number Information
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NPI Number | 1124089479
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Entity Type | Organization
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Legal Business Name | ABSOLUTE FOOT AND ANKLE CLINIC LTD
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 3546 N MILWAUKEE AVE
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City | NORTHBROOK
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State | IL
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Zip | 60062
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Country | US
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Telephone | 847-297-9660
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Fax | 847-297-9665
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Provider Business Mailing Address
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Address Line | 3546 N MILWAUKEE AVE
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City | NORTHBROOK
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State | IL
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Zip | 60062
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Country | US
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Telephone | 847-297-9660
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Fax | 847-297-9665
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZINOVIY RABINOVICH
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Credential | DPM
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Telephone | 847-297-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016005115
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License Number State | IL
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