Alliance Foot & Ankle Clinics LLC
Organization Active NPI Foot & Ankle Surgery Podiatrist · Zion, IL
NPI 1366995136 · NPPES record last updated Jul 31, 2018
Key facts
- NPI
- 1366995136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 016.005682 (IL)
- Legal business name
- ALLIANCE FOOT & ANKLE CLINICS LLC
- Practice address
- 2640 Sheridan Rd
Zion, IL 60099-2615 - Phone
- (847) 746-2922
- Fax
- (847) 746-9344
- NPI assigned
- Jul 28, 2016
- Organization subpart
- No
Authorized official
- Name
- Juan Carlos Jon
- Title
- General Manager
- Phone
- (414) 282-7209
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Practitioners 4
-
Cynthia Rae Cernak, D.P.M.
-
Ivelisse Vargas Jon, DPM
-
Donna Jean Hayes, DPM
-
Jacob Valabov, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160408000396 | IL | DME Supplier - Physician - Podiatry | 1355562604 |
1 other NPI on this enrollment Practice locations: Zion, IL |
National Provider Directory
- Tax ID family
- Alliance Foot and Ankle Clinics LLC
Locations
6123 Green Bay Rd
Ste 260
Kenosha, WI 53142
Phone (262) 731-0077
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | 016.005682 | IL | Yes |
Addresses
Primary practice location
2640 Sheridan Rd
Zion, IL 60099-2615
Mailing address
2640 Sheridan Rd
Zion, IL 60099-2615
Phone (847) 746-2922
Other providers in Zion, IL
- A Little Help, LLC
- Celia Anita Abdullah-Baker
- Tara Thananetapon Alaichamy
- Mohammed Alchaar
- Imani Allen
- Allure Alf Operator LLC
- Allure Alf Operator LLC
- Alpha Care Enterprises of Il LLC
- Alpine Care of Zion, LLC
- American Drug Stores LLC
All providers in Zion, IL · Foot & Ankle Surgery Podiatrist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.