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Organization

CHICAGO FOOT AND ANKLE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES TIMOTHY ALLEN DPM (OWNER)
(773) 925-5700
Entity
Organization

Contact information

Practice address
5700 S KEDZIE AVE, CHICAGO, IL 60629-2408
(773) 925-5700
(773) 925-5775
Mailing address
5700 S KEDZIE AVE, CHICAGO, IL 60629-2408
(773) 925-5700
(773) 925-5775

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01638903
BLUE CROSS BLUE SHIELD
IL
01
D08726
RAILROAD MEDICARE
IL
Enumeration date
03/10/2008
Last updated
04/30/2015
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