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General NPI Number Information
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NPI Number | 1194777698
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Entity Type | Organization
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Legal Business Name | TALCOTT FOOT&ANKLE SPECIALISTS,PC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT SUITE 214
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City | CHICAGO
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State | IL
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Zip | 60631
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Country | US
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Telephone | 773-594-9700
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Fax | 773-594-0095
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT SUITE 214
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City | CHICAGO
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State | IL
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Zip | 60631
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Country | US
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Telephone | 773-594-9700
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Fax | 773-594-0095
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN J TENCZAR
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Credential |
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Telephone | 773-594-9700
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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 | 060-008508
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License Number State | IL
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