Provider Demographics
NPI:1619081239
Name:ASSOCIATED FOOT SURGEONS OF CHICAGOLAND LTD
Entity Type:Organization
Organization Name:ASSOCIATED FOOT SURGEONS OF CHICAGOLAND LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-323-1038
Mailing Address - Street 1:15 SPINNING WHEEL RD STE 114
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2983
Mailing Address - Country:US
Mailing Address - Phone:630-323-1038
Mailing Address - Fax:630-323-2059
Practice Address - Street 1:15 SPINNING WHEEL RD STE 114
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2983
Practice Address - Country:US
Practice Address - Phone:630-323-1038
Practice Address - Fax:630-323-2059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060002284213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
379320Medicare ID - Type Unspecified