Provider Demographics
NPI:1134802739
Name:ABSOLUTE FOOT AND ANKLE SURGERY LLC
Entity type:Organization
Organization Name:ABSOLUTE FOOT AND ANKLE SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CKLAMOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-925-8207
Mailing Address - Street 1:8208 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-1010
Mailing Address - Country:US
Mailing Address - Phone:312-925-8207
Mailing Address - Fax:708-398-9777
Practice Address - Street 1:8208 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60480-1010
Practice Address - Country:US
Practice Address - Phone:708-630-2017
Practice Address - Fax:708-398-9777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528563483OtherINDIVIDUAL NPI