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Organization

SPACCAPANICCIA PODIATRY LTD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER CKLAMOVSKI (OWNER)
(630) 495-3338
Entity
Organization

Contact information

Practice address
2340 S HIGHLAND AVE STE 100, LOMBARD, IL 60148-7131
(630) 495-3338
(630) 495-3350
Mailing address
2340 S HIGHLAND AVE, LOMBARD, IL 60148-5371
(630) 495-3338

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016-003407
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
1
01
0060015180
BCBS
IL
01
0060015182
BCBS
IL
01
CN8416
MEDICARE RAILROAD
IL
Enumeration date
03/06/2007
Last updated
04/29/2025
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