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General NPI Number Information
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NPI Number | 1750312690
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Entity Type | Organization
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Legal Business Name | MITCHELL FOOT & ANKLE PC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 1424 E 53RD ST SUITE 301
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City | CHICAGO
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State | IL
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Zip | 60615-4500
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Country | US
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Telephone | 773-324-3338
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Fax | 773-324-1866
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Provider Business Mailing Address
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Address Line | 1424 E 53RD ST SUITE 301
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City | CHICAGO
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State | IL
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Zip | 60615-4500
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Country | US
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Telephone | 773-324-3338
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Fax | 773-324-1866
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES L MITCHELL
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Credential | DPM
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Telephone | 773-324-3338
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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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