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Organization
ADVANCED ANKLE AND FOOT SURGEONS, LLC
Active
Organization
ADVANCED ANKLE AND FOOT SURGEONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE TAYLOR JD (CFO)
(618) 960-1836
Entity
Organization
Contact information
Practice address
4905 STONE FALLS CTR STE B, O FALLON, IL 62269-7802
(618) 277-0001
(618) 277-7339
Mailing address
4905 STONE FALLS CTR STE B, O FALLON, IL 62269-7802
(618) 277-0001
(618) 277-7339
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016.004852
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6242980002
PTAN
IL
Enumeration date
09/17/2009
Last updated
05/29/2019
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