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General NPI Number Information
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NPI Number | 1932742848
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE CARE & ASSOCIATES, LTD
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 3320 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-3317
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Country | US
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Telephone | 773-424-8370
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Fax | 773-424-8436
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Provider Business Mailing Address
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Address Line | 3320 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-3317
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Country | US
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Telephone | 773-424-8370
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Fax | 773-424-8436
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Authorized Official
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Title or Position | OWNER
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Name | ATIYEH SALEM
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Credential | DPM
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Telephone | 773-424-8370
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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 |
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License Number State |
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