Provider Demographics
NPI:1740534742
Name:ABSOLUTE FOOT AND ANKLE CLINIC, LTD
Entity type:Organization
Organization Name:ABSOLUTE FOOT AND ANKLE CLINIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZINOVIY
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-297-9660
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:3546 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7130
Practice Address - Country:US
Practice Address - Phone:847-297-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABSOLUTE FOOT AND ANKLE CLINIC, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site