Organization
FOX VALLEY FOOT AND ANKLE SPECIALIST, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MONDUL (OWNER)
(630) 232-1013
Entity
Organization
Contact information
Practice address
2401 KANEVILLE RD STE 6, GENEVA, IL 60134-2577
(630) 232-1013
(630) 232-1014
Mailing address
PO BOX 762, GENEVA, IL 60134-0762
(630) 232-1013
(630) 232-1014
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016003529
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60001518
BCBS
IL
Enumeration date
12/10/2007
Last updated
07/08/2008
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