MEDICARE: AMERICAN FOOT CARE 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	261QP1100X	Podiatric Clinic/Center	016-004714	IL
2	261QP1100X	Podiatric Clinic/Center	016-004735	IL

General Provider Information

NPI Number	:	1871820381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN FOOT CARE CENTER

Provider Business Mailing Address
First Line	:	1757 RIDGE RD
Second Line	:	SUITE 102
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-1812
Country	:	US
Telephone Number	:	708-799-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1757 RIDGE RD
Second Line	:	SUITE 102
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-1812
Country	:	US
Telephone Number	:	708-799-7500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY TODD HORAK
Credential	:	DPM
Telephone Number	:	708-799-7500

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	11/05/2009

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Directions to “AMERICAN FOOT CARE CENTER ” Practice Location

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