Provider Demographics
NPI:1497108658
Name:FOOT & ANKLE HEALTH CENTER, P.C.
Entity Type:Organization
Organization Name:FOOT & ANKLE HEALTH CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-373-0909
Mailing Address - Street 1:6883 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5294
Mailing Address - Country:US
Mailing Address - Phone:630-373-0909
Mailing Address - Fax:
Practice Address - Street 1:5716 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2345
Practice Address - Country:US
Practice Address - Phone:630-373-0909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005610213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty