Provider Demographics
NPI:1437237534
Name:MERCADO CENTER FOR FOOT & ANKLE SURGERY
Entity Type:Organization
Organization Name:MERCADO CENTER FOR FOOT & ANKLE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-383-6800
Mailing Address - Street 1:6545 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1020
Mailing Address - Country:US
Mailing Address - Phone:708-383-6800
Mailing Address - Fax:708-383-6827
Practice Address - Street 1:6545 NORTH AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1020
Practice Address - Country:US
Practice Address - Phone:708-383-6800
Practice Address - Fax:708-383-6827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty