Organization
DUPAGE FOOT AND ANKLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD E NICHOLS II DPM (PRESIDENT/OWNER)
(630) 842-8891
Entity
Organization
Contact information
Practice address
1525 N MAIN ST, WHEATON, IL 60187-3583
(630) 538-3668
(630) 480-7423
Mailing address
1525 N MAIN ST, WHEATON, IL 60187-3583
(630) 538-3668
(630) 480-7423
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
016-004441
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-004441
LICENSE NUMBER
IL
05
—
016004441
—
IL
Enumeration date
06/20/2013
Last updated
03/07/2023
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