Provider Demographics
NPI:1851302293
Name:CHICAGOLAND FOOT AND ANKLE, PC
Entity Type:Organization
Organization Name:CHICAGOLAND FOOT AND ANKLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-239-0702
Mailing Address - Street 1:3260 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2205
Mailing Address - Country:US
Mailing Address - Phone:773-239-0702
Mailing Address - Fax:773-239-0712
Practice Address - Street 1:3260 W 111TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655
Practice Address - Country:US
Practice Address - Phone:773-239-0702
Practice Address - Fax:773-239-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001636066OtherBCBS
ILDF7576OtherRAILROAD MEDICARE
IL0001636066OtherBCBS
IL5655350001Medicare NSC