Organization
PERFORMANCE FOOT AND ANKLE CENTER LLC
Active
Parent organization
PERFORMANCE FOOT AND ANKLE CENTER LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERFORMANCE FOOT AND ANKLE CENTER LLC
Authorized official
DR. DALE S BRINK DPM (OWNER)
(708) 596-3757
Entity
Organization
Contact information
Practice address
15300 WEST AVE, SUITE 210, ORLAND PARK, IL 60462-4600
(708) 873-9440
(708) 873-1862
Mailing address
401 E 162ND ST, SUITE 101, SOUTH HOLLAND, IL 60473-2236
(708) 596-3757
(708) 596-3779
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004747
IL
332B00000X
Durable Medical Equipment & Medical Supplies
5000520001
IL
Other
Enumeration date
01/31/2008
Last updated
07/16/2015
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