Provider Demographics
NPI:1356483150
Name:FOOT & ANKLE CENTER
Entity Type:Organization
Organization Name:FOOT & ANKLE CENTER
Other - Org Name:GEORGE CARIOSCIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARIOSCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-582-3338
Mailing Address - Street 1:117 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1006
Mailing Address - Country:US
Mailing Address - Phone:630-582-3338
Mailing Address - Fax:630-582-3316
Practice Address - Street 1:117 W LAKE ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1006
Practice Address - Country:US
Practice Address - Phone:630-582-3338
Practice Address - Fax:630-582-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004560302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU27163Medicare UPIN
IL0571470001Medicare NSC