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Individual

ALAN J TENCZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7447 W TALCOTT AVE, STE 214, CHICAGO, IL 60631-3745
(773) 594-9700
(773) 594-0095
Mailing address
7447 W TALCOTT AVE, STE 214, CHICAGO, IL 60631-3745
(773) 594-9700
(773) 594-0095

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
00438
IA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-003540
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
272
NE
213ES0103X
Foot & Ankle Surgery Podiatrist
E3591
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016003540
IL
01
0707390001
DMERC
IL
01
480020436
MEDICARE RR PROVIDER#
IL
01
60001380
BCBS OF ILLINOIS
IL
01
CE8840
MEDICARE RR GROUP NUMBER
IL
Enumeration date
05/16/2006
Last updated
04/22/2008
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