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Contact Information

ADVANCED FOOT AND ANKLE CENTER OF KENOSHA S.C.
2901 35TH ST
LOWER LEVEL SOUTH
KENOSHA, WI53140-5117
 Phone: 262-652-6555
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ADVANCED FOOT AND ANKLE CENTER OF KENOSHA S.C.

NPI # 1104279561
LBN Legal business name ADVANCED FOOT AND ANKLE CENTER OF KENOSHA S.C.
Authorized official DANA DEROUIN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/20/2016
Last updated 07/20/2016 - About 10 years ago
Identifiers
WI License # 1029-25
IL Other 1598059354 NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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