Provider Demographics
NPI:1477713212
Name:PREMIER FOOT & ANKLE PC
Entity Type:Organization
Organization Name:PREMIER FOOT & ANKLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-419-3939
Mailing Address - Street 1:165 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1783
Mailing Address - Country:US
Mailing Address - Phone:847-419-3939
Mailing Address - Fax:224-676-0448
Practice Address - Street 1:165 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 170
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1783
Practice Address - Country:US
Practice Address - Phone:847-419-3939
Practice Address - Fax:224-676-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004807213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01639893OtherBCBS
IL01639893OtherBCBS
216868Medicare PIN