Organization
FOOT & ANKLE HEALTHCARE CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM GOSHKO (OWNER)
(773) 205-0106
Entity
Organization
Contact information
Practice address
5501 W BELMONT AVE, CHICAGO, IL 60641-4130
(609) 703-5097
Mailing address
5501 W BELMONT AVE, CHICAGO, IL 60641-4130
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
016004989
IL
Other
Enumeration date
08/17/2016
Last updated
12/19/2018
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