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Organization

A BRIDGEPORT FOOT AND ANKLE CLINIC, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SIDNEY WEISER DPM (PRESIDENT/OWNER)
(312) 225-2444
Entity
Organization

Contact information

Practice address
9933 LAWLER AVE, SUITE 225, SKOKIE, IL 60077-3703
(312) 225-2444
(847) 674-2113
Mailing address
3058 W PETERSON, CHICAGO, IL 60659
(312) 225-2444
(847) 674-2113

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016004192
IL
01
01635040
BCBS
IL
Enumeration date
08/30/2006
Last updated
07/21/2022
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