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General NPI Number Information
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NPI Number | 1588327134
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE WELLNESS CENTER, PC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 3540 SEVEN BRIDGES DR STE 290
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City | WOODRIDGE
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State | IL
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Zip | 60517-1688
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Country | US
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Telephone | 630-852-8522
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Fax |
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Provider Business Mailing Address
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Address Line | 3540 SEVEN BRIDGES DR STE 290
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City | WOODRIDGE
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State | IL
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Zip | 60517-1688
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Country | US
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Telephone | 630-852-8522
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. MANISH ROHIT PANDYA
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Credential | DPM
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Telephone | 847-800-4530
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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 |
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License Number State |
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