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General NPI Number Information
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NPI Number | 1750453734
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Entity Type | Organization
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Legal Business Name | AMERICAN FOOT CARE CENTER INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 1757 RIDGE RD SUITE 102
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City | HOMEWOOD
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State | IL
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Zip | 60430-1812
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Country | US
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Telephone | 708-798-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1757 RIDGE RD SUITE 102
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City | HOMEWOOD
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State | IL
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Zip | 60430-1812
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Country | US
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Telephone | 708-798-7500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIA EVE SHAUGER
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Credential | D.P.M.
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Telephone | 708-798-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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