Provider Demographics
NPI:1760829667
Name:KAZMER FOOT AND ANKLE CENTERS, LTD
Entity Type:Organization
Organization Name:KAZMER FOOT AND ANKLE CENTERS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAZMER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-378-1000
Mailing Address - Street 1:1710 N RANDALL RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-9401
Mailing Address - Country:US
Mailing Address - Phone:847-277-1376
Mailing Address - Fax:773-521-4260
Practice Address - Street 1:1710 N RANDALL RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-9400
Practice Address - Country:US
Practice Address - Phone:847-277-1376
Practice Address - Fax:773-521-4260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004634213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty