Basic Information
| Provider Information | |||||||||
| NPI: | 1659368918 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KANIA | ||||||||
| FirstName: | FRANCIS | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1943 S MANNHEIM RD | ||||||||
| Address2: | |||||||||
| City: | WESTCHESTER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601544322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083523338 | ||||||||
| FaxNumber: | 7083529933 | ||||||||
| Practice Location | |||||||||
| Address1: | 1943 S MANNHEIM RD | ||||||||
| Address2: | |||||||||
| City: | WESTCHESTER | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601544322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083523338 | ||||||||
| FaxNumber: | 7083529933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2005 | ||||||||
| LastUpdateDate: | 01/05/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 016-004236 | IL | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | 332B00000X | 016-004236 | IL | N | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 480006642 | 01 | RRB PTAN NUMBER | OTHER | 016004236 | 05 | IL | MEDICAID |