Provider Demographics
NPI:1396419743
Name:FOOT & ANKLE ASSOCIATES LTD
Entity Type:Organization
Organization Name:FOOT & ANKLE ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-424-3201
Mailing Address - Street 1:4650 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-1836
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:10811 W 143RD ST STE 100
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-1948
Practice Address - Country:US
Practice Address - Phone:708-424-3201
Practice Address - Fax:708-424-5001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT & ANKLE ASSOCIATES LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-08
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies