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General NPI Number Information
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NPI Number | 1528270766
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Entity Type | Organization
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Legal Business Name | UNITED FOOT & ANKLE SURGEONS, P.C.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1640 PLEASANT LN
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City | GLENVIEW
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State | IL
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Zip | 60025-1847
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Country | US
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Telephone | 773-989-2500
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Fax | 877-834-6714
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Provider Business Mailing Address
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Address Line | 1640 PLEASANT LN
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City | GLENVIEW
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State | IL
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Zip | 60025-1847
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Country | US
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Telephone | 773-989-2500
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Fax | 773-989-0011
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAE-JUN AHN
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Credential | D.P.M.
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Telephone | 773-989-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016-005105
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License Number State | IL
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