Lake Shore Podiatry Center, Llc in Chicago - Podiatrist
Lake Shore Podiatry Center, Llc - NPI 1679670905
Lake Shore Podiatry Center, Llc is a Podiatrist in Chicago, Illinois. Lake Shore Podiatry Center, Llc practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Lake Shore Podiatry Center, Llc is 1679670905. The last update date is 2008-02-14.
Lake Shore Podiatry Center, Llc's current location address is 2143 W Wellington Ave, Chicago, Illinois. You can contact this provider via phone number 7738712250 and fax number 7736970134. The mailing address for Lake Shore Podiatry Center, Llc is 2143 W Wellington Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Shore Podiatry Center, Llc |
|---|---|
| Address | 2143 W Wellington Ave, Chicago, Illinois |
| Phone Number | 7738712250 |
| Fax Number | 7736970134 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Massuda Fortunee |
| Credentials | DPM |
| Telephone Number | 7732330590 |
NPI Number Detail
| NPI Number | 1679670905 |
|---|---|
| Provider Enumeration Date | 2006-09-20 |
| Last Updated Date | 2008-02-14 |
Provider Mailing Address Detail
| Address | 2143 W Wellington Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606188268 |
| Phone Number | 7738712250 |
| Fax Number | 7736970134 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
|
Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 216-22095 | IL | BCBS |
Post Comment/ Review Below
What is the unique identifier code issued to Lake Shore Podiatry Center, Llc by the Centers for Medicare & Medicaid Services?
The Lake Shore Podiatry Center, Llc has been assigned the NPI (National Provider Identifier) 1679670905. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Lake Shore Podiatry Center, Llc is located?
The Lake Shore Podiatry Center, Llc is situated at the following address: 2143 W Wellington Ave, Chicago, IL, 606188268.
What is Lake Shore Podiatry Center, Llc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Lake Shore Podiatry Center, Llc is Podiatrist, and the taxonomy classification code that categorizes this area of expertise is 213E00000X.
On what date did the Lake Shore Podiatry Center, Llc receive the assignment of its 1679670905 from the Centers for Medicare & Medicaid Services?
The Lake Shore Podiatry Center, Llc was issued its 1679670905 by the Centers for Medicare & Medicaid Services on 2006-09-20.
When was the information pertaining to Lake Shore Podiatry Center, Llc most recently updated or revised?
The details related to Lake Shore Podiatry Center, Llc, including its address, specialty, and other relevant information, were last updated or revised on 2008-02-14.
NPI Number: 1609879220
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