MEDICARE: FOOT & ANKLE HEALTH CARE CENTER LTD

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	213EP1101X	Primary Podiatric Medicine Podiatrist	016004982	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619014065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT & ANKLE HEALTH CARE CENTER LTD

Provider Business Mailing Address
First Line	:	5501 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4130
Country	:	US
Telephone Number	:	773-205-0106
Fax Number	:

Provider Business Practice Location Address
First Line	:	6037 S ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2859
Country	:	US
Telephone Number	:	773-585-8003
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. GALINA PODOLSKAYA
Credential	:	D.P.M.
Telephone Number	:	773-205-0106

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	01/23/2019

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