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General NPI Number Information
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NPI Number | 1194043539
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Entity Type | Organization
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Legal Business Name | TRUE CARE FOOT AND ANKLE INSTITUTE PC
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 9500 W LINCOLN HWY UNIT 6
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City | FRANKFORT
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State | IL
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Zip | 60423-1939
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Country | US
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Telephone | 815-464-4723
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Fax | 815-277-2456
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Provider Business Mailing Address
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Address Line | 9500 W LINCOLN HWY UNIT 6
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City | FRANKFORT
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State | IL
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Zip | 60423-1939
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Country | US
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Telephone | 815-464-4723
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Fax | 815-277-2456
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MONIF MOUSSA MATOUK
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Credential | DPM
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Telephone | 815-534-5724
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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 | 016-005096
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License Number State | IL
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