Organization
SUBURBAN FOOT & ANKLE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAURA A DAVIS (OFFICE MANAGER)
(630) 226-9860
Entity
Organization
Contact information
Practice address
215 REMINGTON BLVD STE A2, BOLINGBROOK, IL 60440-3657
(630) 226-9860
(630) 312-8662
Mailing address
215 REMINGTON BLVD STE A2, BOLINGBROOK, IL 60440-3657
(630) 226-9860
(630) 312-8662
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09922757
BCBS OF IL
IL
Enumeration date
05/15/2007
Last updated
01/24/2023
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