Organization Name: | ADVANCED FOOT & ANKLE SPECIALISTS SC |
NPI Number: | 1023334935 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY F. OCHWAT (PRESIDENT) |
Mailing Address: | 1750 N Randall Rd Suite 160 Elgin |
State: | IL US |
Postal Code: | 601237900 |
Phone Number: | 6306983637 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2010 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 016005296 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |