| Organization Name: | OLYMPIA FOOT & ANKLE CARE, LTD. |
| NPI Number: | 1174663983 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN JAMES O'CONNOR (OWNER) |
| Mailing Address: | 3347 Vollmer Rd Flossmoor |
| State: | IL US |
| Postal Code: | 604222003 |
| Phone Number: | 7087992900 |
| Fax Number: | 7087992919 |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 01/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 016003696 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |