# CHICAGO FOOT & ANKLE CLINIC

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

## Provider details

- **NPI number:** 1891040424
- **Authorized official:** SHAWNI MOSHI (CEO)
- **Authorized official phone:** (773) 376-7200

## Contact information

- **Practice address:** 2801 W CERMAK RD, CHICAGO, IL 60623-3513
- **Practice address phone:** (773) 376-7200
- **Practice address fax:** (773) 376-9211
- **Mailing address:** 2801 W CERMAK RD, CHICAGO, IL 60623-3513
- **Mailing address phone:** (773) 376-7200
- **Mailing address fax:** (773) 376-9211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 016004154 | IL | Yes |

## Other

- **Enumeration date:** 07/19/2012
- **Last updated:** 07/19/2012