Provider Demographics
NPI:1003400730
Name:RT FOOT AND ANKLE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:RT FOOT AND ANKLE SPECIALISTS, LLC
Other - Org Name:ILLINOIS PODITRY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAMSHA
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:TANWIR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-392-1484
Mailing Address - Street 1:2734 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-1504
Mailing Address - Country:US
Mailing Address - Phone:630-392-1484
Mailing Address - Fax:
Practice Address - Street 1:950 N YORK RD STE 105
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8608
Practice Address - Country:US
Practice Address - Phone:630-392-1484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty