| Performance Foot And Ankle Center Llc | |
|
401 E 162nd St, Suite 101, South Holland, IL 60473-2236 | |
| (708) 596-3757 | |
| (708) 596-3779 |
| Full Name | Performance Foot And Ankle Center Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 401 E 162nd St, South Holland, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750397428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (Illinois) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 5000520001 (Illinois) | Secondary |
| Provider Name | Timothy J Krygsheld |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104833292 PECOS PAC ID: 5294629697 Enrollment ID: I20040211000193 |
| Provider Name | Dale Steven Brink |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1093722365 PECOS PAC ID: 6204720600 Enrollment ID: I20040211000373 |
| Provider Name | Brian C Wittmayer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174671333 PECOS PAC ID: 8820181548 Enrollment ID: I20070911000324 |
| Provider Name | Vivek N Patel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194165357 PECOS PAC ID: 3678863230 Enrollment ID: I20160609001998 |
| Mailing Address | Practice Location Address |
|---|---|
| Performance Foot And Ankle Center Llc 401 E 162nd St, Suite 101, South Holland, IL 60473-2236 Ph: (708) 596-3757 | Performance Foot And Ankle Center Llc 401 E 162nd St, Suite 101, South Holland, IL 60473-2236 Ph: (708) 596-3757 |
Dr. Dale Steven Brink, DPM, FACFAS Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 E 162nd St Ste 101, South Holland, IL 60473 Phone: 708-596-3757 Fax: 708-596-3779 | |
Dr. Timothy J Krygsheld, DPM, FACFAS Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 E 162nd St Ste 101, South Holland, IL 60473 Phone: 708-596-3757 Fax: 708-596-3779 | |
Dr. Brian C. Wittmayer, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 401 E. 162nd St, Suite 101, South Holland, IL 60473 Phone: 708-596-3757 Fax: 708-596-3779 | |
Vivek Patel, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 E 162nd St, Suite 101, South Holland, IL 60473 Phone: 708-596-3757 |