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General NPI Number Information
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NPI Number | 1235384488
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Entity Type | Organization
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Legal Business Name | MIKLOS FOOT AND ANKLE SPECIALISTS, PC
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 6634 W ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2408
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Country | US
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Telephone | 773-586-5487
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Fax | 773-586-9523
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Provider Business Mailing Address
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Address Line | 6634 W ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2408
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Country | US
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Telephone | 773-586-5487
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Fax | 773-586-9523
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. ROBERT C MIKLOS
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Credential | DPM
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Telephone | 773-586-5487
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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 | 016003168
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License Number State | IL
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