MEDICARE: OPENSKY PODIATRY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	016005221	IL

General Provider Information

NPI Number	:	1023419538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPENSKY PODIATRY INC.

Provider Business Mailing Address
First Line	:	6225 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2818
Country	:	US
Telephone Number	:	708-747-8994
Fax Number	:	847-965-6325

Provider Business Practice Location Address
First Line	:	6225 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2818
Country	:	US
Telephone Number	:	708-747-8994
Fax Number	:	847-965-6325

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIAN ANDREW OPENSKY
Credential	:	DPM
Telephone Number	:	708-747-8994

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	12/06/2024

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