Lake Shore Podiatry Center, Llc in Chicago - Primary Podiatric Medicine
Lake Shore Podiatry Center, Llc - NPI 1366434706
Lake Shore Podiatry Center, Llc is a Primary Podiatric Medicine in Chicago, Illinois. Lake Shore Podiatry Center, Llc practices all healthcare services and medical treatments related to Primary Podiatric Medicine. The NPI Number for Lake Shore Podiatry Center, Llc is 1366434706. The last update date is 2008-07-03.
Lake Shore Podiatry Center, Llc's current location address is 2511 N Kedzie Blvd, Chicago, Illinois. You can contact this provider via phone number 7733425850 and fax number 7734897729. The mailing address for Lake Shore Podiatry Center, Llc is 2511 N Kedzie Blvd, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Shore Podiatry Center, Llc |
|---|---|
| Address | 2511 N Kedzie Blvd, Chicago, Illinois |
| Phone Number | 7733425850 |
| Fax Number | 7734897729 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Massuda Fortunee |
| Credentials | DPM |
| Telephone Number | 7733425850 |
NPI Number Detail
| NPI Number | 1366434706 |
|---|---|
| Provider Enumeration Date | 2005-08-22 |
| Last Updated Date | 2008-07-03 |
Provider Mailing Address Detail
| Address | 2511 N Kedzie Blvd |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606472634 |
| Phone Number | 7733425850 |
| Fax Number | 7734897729 |
Provider's Primary Taxonomy Detail
| Speciality | Primary Podiatric Medicine |
|---|---|
| Taxonomy | 213Ep1101X |
|
Definition: A doctor of podiatric medicine expert in general podiatry health services related to medical diagnoses and treatment of the foot, ankle and lower extremities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 216-22095 | IL | BCBS |
Post Comment/ Review Below
What is the unique provider identifier assigned to Lake Shore Podiatry Center, Llc?
The Lake Shore Podiatry Center, Llc has been issued the NPI (National Provider Identifier) 1366434706 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where Lake Shore Podiatry Center, Llc's facilities are situated?
The facilities of Lake Shore Podiatry Center, Llc are physically located at the following address: 2511 N Kedzie Blvd, Chicago, IL, 606472634.
What is the Lake Shore Podiatry Center, Llc's area of specialization and corresponding taxonomy classification?
The Lake Shore Podiatry Center, Llc's specialty field is Primary Podiatric Medicine, and it falls under the taxonomy code 213Ep1101X, which categorizes healthcare providers based on their specialties.
When was the Lake Shore Podiatry Center, Llc's 1366434706 issued?
The Lake Shore Podiatry Center, Llc's 1366434706 was issued on 2005-08-22.
As of what date were the details related to Lake Shore Podiatry Center, Llc most recently updated or revised?
The information pertaining to Lake Shore Podiatry Center, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2008-07-03.