Organization
ARCHER FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIN MASHOUF MHA (ADMIN)
(773) 284-9660
Entity
Organization
Contact information
Practice address
3113 S ARCHER AVE, CHICAGO, IL 60608-6223
(773) 284-9660
(773) 284-9676
Mailing address
PO BOX 11232, CHICAGO, IL 60611-0232
(773) 284-9660
(773) 284-9676
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005501
IL
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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