Provider Demographics
NPI:1619014065
Name:FOOT & ANKLE HEALTH CARE CENTER LTD
Entity Type:Organization
Organization Name:FOOT & ANKLE HEALTH CARE CENTER LTD
Other - Org Name:EUROPEAN FOOT & ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PODOLSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-205-0106
Mailing Address - Street 1:5501 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-4130
Mailing Address - Country:US
Mailing Address - Phone:773-205-0106
Mailing Address - Fax:
Practice Address - Street 1:6037 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2859
Practice Address - Country:US
Practice Address - Phone:773-585-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004982213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004982Medicaid