| Foot And Wound Institute Llc | |
|
475 Doxbury Ln New Lenox IL 60451-3454 | |
| (708) 271-3537 | |
| Not Available |
| Full Name | Foot And Wound Institute Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 475 Doxbury Ln, New Lenox, Illinois |
| Authorized Official Name and Position | Adanna C Okolie (DIRECTOR) |
| Authorized Official Contact | 7082713537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foot And Wound Institute Llc 475 Doxbury Ln New Lenox IL 60451-3454 Ph: (708) 271-3537 | Foot And Wound Institute Llc 475 Doxbury Ln New Lenox IL 60451-3454 Ph: (708) 271-3537 |
| NPI Number | 1043999642 |
|---|---|
| Provider Enumeration Date | 07/12/2023 |
| Last Update Date | 07/12/2023 |
| Medicare PECOS PAC ID | 7517314859 |
|---|---|
| Medicare Enrollment ID | O20231108002692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043999642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
| Provider Name | Adanna Chinonso Okolie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043927874 PECOS PAC ID: 1557735099 Enrollment ID: I20230323001050 |
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