Provider Demographics
NPI:1447072210
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:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
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:60655-2729
Mailing Address - Country:US
Mailing Address - Phone:773-239-0702
Mailing Address - Fax:
Practice Address - Street 1:824 W BARTLETT RD UNIT 2A
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4402
Practice Address - Country:US
Practice Address - Phone:630-855-5687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty