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General NPI Number Information
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NPI Number | 1437296993
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE HEALTH CARE CENTER LTD
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 3541 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3219
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Country | US
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Telephone | 773-478-3782
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60641-4130
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Country | US
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Telephone | 773-205-0106
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GALINA PODOLSKAYA
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Credential | D.P.M.
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Telephone | 773-205-0106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 016004982
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License Number State | IL
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