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General NPI Number Information
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NPI Number | 1447524269
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Entity Type | Organization
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Legal Business Name | DR. GJ WINTERS FOOT-ANKLE LTD
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Dates
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Enumeration Date | 02/24/2012
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 770 BARRON BLVD
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City | GRAYSLAKE
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State | IL
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Zip | 60030-1330
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Country | US
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Telephone | 847-223-4000
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Fax | 847-223-9171
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Provider Business Mailing Address
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Address Line | 770 BARRON BLVD
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City | GRAYSLAKE
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State | IL
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Zip | 60030-1330
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Country | US
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Telephone | 847-223-4000
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Fax | 847-223-9171
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Authorized Official
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Title or Position | OWNER
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Name | GRIFF J WINTERS
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Credential | DPM
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Telephone | 847-223-4000
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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 | 016003420
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License Number State | IL
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