Provider Demographics
NPI:1437292141
Name:GENEVA FOOT & ANKLE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:GENEVA FOOT & ANKLE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:TSANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-208-0202
Mailing Address - Street 1:1705 SOUTH ST
Mailing Address - Street 2:STE A
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2583
Mailing Address - Country:US
Mailing Address - Phone:630-208-0202
Mailing Address - Fax:630-208-8341
Practice Address - Street 1:1705 SOUTH ST
Practice Address - Street 2:STE A
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2583
Practice Address - Country:US
Practice Address - Phone:630-208-0202
Practice Address - Fax:630-208-8341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL511240Medicare ID - Type Unspecified