Provider Demographics
NPI:1447524269
Name:DR. GJ WINTERS FOOT-ANKLE LTD
Entity type:Organization
Organization Name:DR. GJ WINTERS FOOT-ANKLE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRIFF
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-223-4000
Mailing Address - Street 1:770 BARRON BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1330
Mailing Address - Country:US
Mailing Address - Phone:847-223-4000
Mailing Address - Fax:847-223-9171
Practice Address - Street 1:770 BARRON BLVD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1330
Practice Address - Country:US
Practice Address - Phone:847-223-4000
Practice Address - Fax:847-223-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003420213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T37946Medicare UPIN