Organization
MERCADO FOOT CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORLANDO A MERCADO D.P.M. (DIRECTOR)
(708) 383-6800
Entity
Organization
Contact information
Practice address
6545 W. NORTH AVE, OAK PARK, IL 60302-1020
(708) 383-6800
(708) 383-6827
Mailing address
6545 W. NORTH AVE, OAK PARK, IL 60302-1020
(708) 383-6800
(708) 383-6827
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016002453
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633089
BC/BS PROVIDER NUMBER
IL
01
—
CL0737
RAILROAD MEDICARE GROUP #
IL
Enumeration date
08/30/2006
Last updated
09/13/2012
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