MEDICARE: ACHILLES HEEL 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	213E00000X	Podiatrist	016.004247	IL

General Provider Information

NPI Number	:	1902178445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACHILLES HEEL LTD

Provider Business Mailing Address
First Line	:	10349 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2410
Country	:	US
Telephone Number	:	773-445-3668
Fax Number	:	773-445-6768

Provider Business Practice Location Address
First Line	:	10349 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2410
Country	:	US
Telephone Number	:	773-445-3668
Fax Number	:	773-445-6768

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID LAWRENCE KAISER
Credential	:	D.P.M.
Telephone Number	:	773-445-3668

Provider Enumeration Date	:	01/30/2012
Last Update Date	:	01/30/2012

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