Organization
ADVANCED ANKLE AND FOOT SURGEONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE TAYLOR JD (CFO)
(618) 960-1836
Entity
Organization
Contact information
Practice address
4905 STONE FALLS CTR STE B, O FALLON, IL 62269-7802
(618) 277-0001
(618) 277-7339
Mailing address
4905 STONE FALLS CTR STE B, O FALLON, IL 62269-7802
(618) 277-0001
(618) 277-7339
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016.004852
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6242980002
PTAN
IL
Enumeration date
09/17/2009
Last updated
05/29/2019
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