Provider Demographics
NPI:1053433854
Name:AFFILIATED ANKLE AND FOOT SURGEONS
Entity type:Organization
Organization Name:AFFILIATED ANKLE AND FOOT SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHNEEBELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-277-9533
Mailing Address - Street 1:4600 MEMORIAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5366
Mailing Address - Country:US
Mailing Address - Phone:618-277-9533
Mailing Address - Fax:618-277-9540
Practice Address - Street 1:4600 MEMORIAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5366
Practice Address - Country:US
Practice Address - Phone:618-277-9533
Practice Address - Fax:618-277-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT35440Medicare UPIN
ILU67700Medicare UPIN