MEDICARE: DR. VINCENT ANTHONY PERNS DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	016002468	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043213713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT ANTHONY PERNS DPM

Provider Business Mailing Address
First Line	:	3115 N HARLEM AVE
Second Line	:	STE 200
City	:	CHICAGO
State	:	IL
Zip	:	60634-4684
Country	:	US
Telephone Number	:	773-836-9900
Fax Number	:	773-836-9935

Provider Business Practice Location Address
First Line	:	3115 N HARLEM AVE
Second Line	:	STE 200
City	:	CHICAGO
State	:	IL
Zip	:	60634-4684
Country	:	US
Telephone Number	:	773-836-9900
Fax Number	:	773-836-9935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/01/2013

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