Provider Demographics
NPI:1740472687
Name:ANKLE & FOOT SURGICENTER
Entity type:Organization
Organization Name:ANKLE & FOOT SURGICENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:ELIPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-588-3338
Mailing Address - Street 1:7437 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3701
Mailing Address - Country:US
Mailing Address - Phone:847-588-3338
Mailing Address - Fax:847-588-3341
Practice Address - Street 1:7437 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3701
Practice Address - Country:US
Practice Address - Phone:847-588-3338
Practice Address - Fax:847-588-3341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37464Medicare UPIN