MEDICARE: M & M FOOT AND ANKLE SPECIALISTS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1083487623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & M FOOT AND ANKLE SPECIALISTS PLLC

Provider Business Mailing Address
First Line	:	404 WOODSIDE DR
Second Line	:
City	:	WOOD DALE
State	:	IL
Zip	:	60191-2535
Country	:	US
Telephone Number	:	630-822-2445
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 N WALNUT ST
Second Line	:
City	:	ITASCA
State	:	IL
Zip	:	60143-1769
Country	:	US
Telephone Number	:	630-822-2445
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MANSOOR AHMED
Credential	:
Telephone Number	:	630-822-2445

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	08/19/2025

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