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General NPI Number Information
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NPI Number | 1972936631
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Entity Type | Organization
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Legal Business Name | BRIDGEVIEW FOOT AND ANKLE, P.C.
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Dates
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Enumeration Date | 08/16/2013
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 7255 W 87TH ST UNIT 1
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City | BRIDGEVIEW
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State | IL
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Zip | 60455-1821
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Country | US
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Telephone | 708-477-6512
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Fax |
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Provider Business Mailing Address
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Address Line | 7255 W 87TH ST UNIT 1
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City | BRIDGEVIEW
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State | IL
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Zip | 60455-1821
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Country | US
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Telephone | 708-477-6512
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Fax |
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Authorized Official
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Title or Position | DPM/PRESIDENT
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Name | MARWA SAYED
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Credential |
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Telephone | 708-446-8158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 016005387
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License Number State | IL
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