Provider Demographics
NPI:1750453734
Name:AMERICAN FOOT CARE CENTER INC
Entity Type:Organization
Organization Name:AMERICAN FOOT CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:SHAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-798-7500
Mailing Address - Street 1:1757 RIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1812
Mailing Address - Country:US
Mailing Address - Phone:708-798-7500
Mailing Address - Fax:
Practice Address - Street 1:1757 RIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1812
Practice Address - Country:US
Practice Address - Phone:708-798-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical