Provider Demographics
NPI:1194397844
Name:FOUNDATION FOOT AND ANKLE CENTER LLC
Entity type:Organization
Organization Name:FOUNDATION FOOT AND ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND AO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:504-410-4702
Mailing Address - Street 1:1012 95TH ST STE 12
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5040
Mailing Address - Country:US
Mailing Address - Phone:630-635-5889
Mailing Address - Fax:630-570-2400
Practice Address - Street 1:1012 95TH ST STE 12
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5040
Practice Address - Country:US
Practice Address - Phone:630-635-5889
Practice Address - Fax:630-570-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies