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General NPI Number Information
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NPI Number | 1699013698
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Entity Type | Organization
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Legal Business Name | KAZMER FOOT AND ANKLE CENTERS LTD
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Dates
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Enumeration Date | 01/25/2013
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 1710 N RANDALL RD STE 140
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City | ELGIN
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State | IL
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Zip | 60123-9401
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Country | US
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Telephone | 847-277-1376
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Fax | 773-521-4260
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Provider Business Mailing Address
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Address Line | 1701 S 1ST AVE STE 503
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City | MAYWOOD
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State | IL
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Zip | 60153-2422
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Country | US
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Telephone | 847-277-1376
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Fax | 773-521-4260
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY M. KAZMER
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Credential | D.P.M.
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Telephone | 773-378-1000
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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 | 016004634
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License Number State | IL
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