Organization
ADVANCED FOOT AND ANKLE SURGEONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS J PACACCIO DPM (PRESIDENT)
(630) 352-3700
Entity
Organization
Contact information
Practice address
2180 OAKLAND DR, UNIT A, SYCAMORE, IL 60178-3122
(815) 669-4811
(815) 986-6062
Mailing address
2180 OAKLAND DR, UNIT A, SYCAMORE, IL 60178-3122
(815) 669-4811
(815) 986-6062
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005351
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005347
—
IL
01
—
1013005867
INDIVIDUAL NPI
IL
01
—
1013113265
INDIVIDUAL NPI
IL
Enumeration date
08/21/2009
Last updated
05/08/2015
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