Libertyville Ankle & Foot Clinic, Inc in Libertyville - Foot & Ankle Surgery
Libertyville Ankle & Foot Clinic, Inc - NPI 1487630406
Libertyville Ankle & Foot Clinic, Inc is a Foot & Ankle Surgery in Libertyville, Illinois. Libertyville Ankle & Foot Clinic, Inc practices all healthcare services and medical treatments related to Foot & Ankle Surgery. The NPI Number for Libertyville Ankle & Foot Clinic, Inc is 1487630406. The last update date is 2014-07-25.
Libertyville Ankle & Foot Clinic, Inc's current location address is 1017 W Park Ave, Libertyville, Illinois. You can contact this provider via phone number 8473621320 and fax number 8473621823. The mailing address for Libertyville Ankle & Foot Clinic, Inc is 1017 W Park Ave, Libertyville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Libertyville Ankle & Foot Clinic, Inc |
|---|---|
| Address | 1017 W Park Ave, Libertyville, Illinois |
| Phone Number | 8473621320 |
| Fax Number | 8473621823 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Jacobsen A Scott |
| Credentials | DPM |
| Telephone Number | 8473621320 |
NPI Number Detail
| NPI Number | 1487630406 |
|---|---|
| Provider Enumeration Date | 2005-12-21 |
| Last Updated Date | 2014-07-25 |
Provider Mailing Address Detail
| Address | 1017 W Park Ave |
|---|---|
| City | Libertyville |
| State | Illinois (IL) |
| Post Code | 600482502 |
| Phone Number | 8473621320 |
| Fax Number | 8473621823 |
Provider's Primary Taxonomy Detail
| Speciality | Foot & Ankle Surgery |
|---|---|
| Taxonomy | 213Es0103X |
| Licence No | 016-005031 |
|
Definition: A doctor of podiatric medicine who diagnoses and treats disorders and injuries to the foot, ankle and related structures. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16005031 | IL | -- | |
| P00347050 | IL | RAILROAD MEDICARE | |
| 4932511 | IL | BLUECROSS |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Libertyville Ankle & Foot Clinic, Inc by the Centers for Medicare & Medicaid Services?
The Libertyville Ankle & Foot Clinic, Inc has been issued the NPI (National Provider Identifier) 1487630406 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Libertyville Ankle & Foot Clinic, Inc?
The Libertyville Ankle & Foot Clinic, Inc is physically situated at 1017 W Park Ave, in the city of Libertyville, state of IL, with the postal code 600482502.
What is Libertyville Ankle & Foot Clinic, Inc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Libertyville Ankle & Foot Clinic, Inc's specialized field of practice is Foot & Ankle Surgery, and the corresponding taxonomy code that categorizes this area of specialization is 213Es0103X.
When did Libertyville Ankle & Foot Clinic, Inc receive its 1487630406 assignment?
The Libertyville Ankle & Foot Clinic, Inc was assigned its 1487630406 on 2005-12-21, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Libertyville Ankle & Foot Clinic, Inc last refreshed?
The information related to the Libertyville Ankle & Foot Clinic, Inc, including its address, specialty, and other relevant details, was last updated on 2014-07-25.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY