Organization Name: | ANKLE AND FOOT ASSOCIATES PC |
NPI Number: | 1114239951 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEORGE CARIOSCIA (PRESIDENT) |
Mailing Address: | 521 S Lagrange Rd Suite 102 Lagrange |
State: | IL US |
Postal Code: | 605255633 |
Phone Number: | 7085790047 |
Fax Number: | 7085790296 |
NPI Enumeration Date: | 07/09/2010 |
NPI Last Update Date: | 03/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 016004560 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |