# ARCHER FOOT CLINIC

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

## Provider details

- **NPI number:** 1700292711
- **Authorized official:** AMIN MASHOUF MHA (ADMIN)
- **Authorized official phone:** (773) 284-9660

## Contact information

- **Practice address:** 3113 S ARCHER AVE, CHICAGO, IL 60608-6223
- **Practice address phone:** (773) 284-9660
- **Practice address fax:** (773) 284-9676
- **Mailing address:** PO BOX 11232, CHICAGO, IL 60611-0232
- **Mailing address phone:** (773) 284-9660
- **Mailing address fax:** (773) 284-9676

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 016005501 | IL | Yes |

## Other

- **Enumeration date:** 07/10/2014
- **Last updated:** 07/10/2014