Provider Demographics
NPI:1194109314
Name:VP FOOT AND ANKLE INC
Entity type:Organization
Organization Name:VP FOOT AND ANKLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RAESTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-259-6922
Mailing Address - Street 1:730 S DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1838
Mailing Address - Country:US
Mailing Address - Phone:312-588-1104
Mailing Address - Fax:312-577-0884
Practice Address - Street 1:730 S DEARBORN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1838
Practice Address - Country:US
Practice Address - Phone:312-588-1104
Practice Address - Fax:312-577-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty