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Organization
CHICAGO FOOT & ORTHOPEDIC CLINIC
Active
Organization
CHICAGO FOOT & ORTHOPEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIN MASHOUF (ADMINISTRATOR)
(773) 376-7200
Entity
Organization
Contact information
Practice address
3918 W 63RD ST, CHICAGO, IL 60629-4604
(773) 376-7200
(773) 376-9211
Mailing address
2801 W CERMAK RD, CHICAGO, IL 60623-3513
(773) 376-7200
(773) 376-9211
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
016004154
IL
Other
Enumeration date
01/10/2013
Last updated
01/10/2013
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