Organization
GREAT LAKES FOOT & ANKLE INSTITUTE PLLC
Active
Parent organization
GREAT LAKES FOOT & ANKLE INSTITUTE PLLC
Other names
Great Lakes Foot and Ankle an Anatomic Pathology Laboratory, GREAT LAKES FOOT & ANKLE INSTITUTE PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT LAKES FOOT & ANKLE INSTITUTE PLLC
Authorized official
STEPHEN FRASCONE DPM (OWNER)
(586) 725-3444
Entity
Organization
Contact information
Practice address
32743 23 MILE RD STE 110, CHESTERFIELD, MI 48047-2082
(586) 725-3444
(586) 725-0984
Mailing address
9400 S CICERO AVE STE 100, OAK LAWN, IL 60453-2536
(708) 424-3201
(708) 424-5001
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
Other
Enumeration date
07/28/2021
Last updated
05/17/2025
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