Provider Demographics
NPI:1609182344
Name:TRI-COUNTY PODIATRY ASSOCIATES LTD
Entity Type:Organization
Organization Name:TRI-COUNTY PODIATRY ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:KIPFERL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-639-2525
Mailing Address - Street 1:912 NORTHWEST HWY
Mailing Address - Street 2:SUITE G-6
Mailing Address - City:FOX RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60021-1925
Mailing Address - Country:US
Mailing Address - Phone:847-639-2525
Mailing Address - Fax:847-639-2522
Practice Address - Street 1:912 NORTHWEST HWY
Practice Address - Street 2:SUITE G-6
Practice Address - City:FOX RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60021-1925
Practice Address - Country:US
Practice Address - Phone:847-639-2525
Practice Address - Fax:847-639-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003640213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty