Organization
MERCADO FOOT AND ANKLE CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES SMITH DPM (PODIATRIST/OWNER/PARTNER)
(708) 748-3337
Entity
Organization
Contact information
Practice address
4143 SAUK TRL, RICHTON PARK, IL 60471-1253
(708) 748-3337
(708) 747-3338
Mailing address
4143 SAUK TRL, RICHTON PARK, IL 60471-1253
(708) 748-3337
(708) 747-3338
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634248
BCBS
—
01
—
705352L
AETNA
—
01
—
P00145458
GBA RAILROAD
—
Enumeration date
07/08/2005
Last updated
04/10/2008
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