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Organization
NORTHSIDE FOOT & ANKLE PC
Active
Organization
NORTHSIDE FOOT & ANKLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY STEPHEN KRUSE DPM (OWNER/CEO)
(312) 280-7886
Entity
Organization
Contact information
Practice address
750 N FRANKLIN ST, STE 102, CHICAGO, IL 60654-6263
(312) 280-7886
(312) 280-9547
Mailing address
750 N FRANKLIN ST, STE 102, CHICAGO, IL 60654-6263
(312) 280-7886
(312) 280-9547
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
NULL
213ES0131X
Foot Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
12/06/2013
Last updated
05/01/2023
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