MEDICARE: WEST CHICAGO FAMILY FOOT CENTER

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	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1124105747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST CHICAGO FAMILY FOOT CENTER

Provider Business Mailing Address
First Line	:	4103 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4313
Country	:	US
Telephone Number	:	773-378-1000
Fax Number	:	773-521-4260

Provider Business Practice Location Address
First Line	:	4103 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4313
Country	:	US
Telephone Number	:	773-378-1000
Fax Number	:	773-521-4260

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. DELIA GARCIA
Credential	:
Telephone Number	:	773-378-1000

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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Directions to “WEST CHICAGO FAMILY FOOT CENTER ” Practice Location

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