# INSTITUTE OF FOOT & ANKLE RECONSTRUCTIVE SURGERY OF ILLINOIS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134663172
- **Authorized official:** DR. AHMAD EL SAMAD DPM (OWNER)
- **Authorized official phone:** (773) 445-8700

## Contact information

- **Practice address:** 9933 S WESTERN AVE, SUITE 102, CHICAGO, IL 60643-1810
- **Practice address phone:** (773) 445-8700
- **Mailing address:** 9120 DOUBLETREE DR S, CROWN POINT, IN 46307-7655
- **Mailing address phone:** (219) 736-1010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 07001024 | IN | Yes |

## Other

- **Enumeration date:** 12/09/2016
- **Last updated:** 01/27/2017