Provider Demographics
NPI:1942474036
Name:FOREST VIEW PODIATRY CENTER
Entity Type:Organization
Organization Name:FOREST VIEW PODIATRY CENTER
Other - Org Name:WILLIAM A. MOHS DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:MOHS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM FACFAS
Authorized Official - Phone:847-991-3111
Mailing Address - Street 1:1760 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1573
Mailing Address - Country:US
Mailing Address - Phone:847-991-3111
Mailing Address - Fax:
Practice Address - Street 1:1760 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-1573
Practice Address - Country:US
Practice Address - Phone:847-991-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213ES0000X
IL16-002796213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL171289OtherMEDICARE NUMBER
IL364130066OtherIPA TAX ID
ILMOH002335OtherIPA - ASSOC. FOOT & ANKLE
ILT36937Medicare UPIN
IL0719710001Medicare NSC
IL521590Medicare PIN