Provider Demographics
NPI:1578769741
Name:FOOT AND ANKLE SPECIALISTS OF FOX VALLEY
Entity Type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF FOX VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:VEKKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-852-8522
Mailing Address - Street 1:3540 SEVEN BRIDGES DR STE 290
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1222
Mailing Address - Country:US
Mailing Address - Phone:630-852-8522
Mailing Address - Fax:630-541-2214
Practice Address - Street 1:2088 OGDEN AVE STE 210
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4385
Practice Address - Country:US
Practice Address - Phone:630-898-9805
Practice Address - Fax:630-541-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty