# PRAIRIE FOOT & ANKLE, P.C.

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

## Provider details

- **NPI number:** 1346752656
- **Authorized official:** DENISE MARY-DANIELLE LEE BSHA/MMHRM (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (224) 227-6973

## Contact information

- **Practice address:** 7447 WEST TALCOTT AVE, SUITE 406, CHICAGO, IL 60163-3275
- **Practice address phone:** (224) 227-6973
- **Practice address fax:** (224) 238-3296
- **Mailing address:** 7447 W TALCOTT AVE STE 406, CHICAGO, IL 60631-3715
- **Mailing address phone:** (224) 227-6973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 016005367 | IL | Yes |

## Other

- **Enumeration date:** 10/26/2017
- **Last updated:** 10/26/2017