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NPI Code Detail

MEDICARE: FOOT & ANKLE HEALTH CARE CENTER LTD

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
1213ES0103XFoot & Ankle Surgery Podiatrist016004982IL

Other Identifiers

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

General Provider Information

NPI Number : 1669772992
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 1700 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-5008
Country : US
Telephone Number : 312-243-3330
Fax Number :
Authorized Official
Title or Position : D.P.M.
Name : GALINA PODOLSKIY
Credential :
Telephone Number : 773-205-0106
Provider Enumeration Date : 11/03/2010
Last Update Date : 01/23/2019

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Directions to “FOOT & ANKLE HEALTH CARE CENTER LTD ” Practice Location

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