MEDICARE: DR. PETER A HANCOCK 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	016002787	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	:	1407850969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER A HANCOCK DPM

Provider Business Mailing Address
First Line	:	30 LAUREL TRL
Second Line	:
City	:	WHEELING
State	:	IL
Zip	:	60090-4416
Country	:	US
Telephone Number	:	847-215-1564
Fax Number	:	847-215-0240

Provider Business Practice Location Address
First Line	:	4646 N MARINE DR
Second Line	:	STE C-6500
City	:	CHICAGO
State	:	IL
Zip	:	60640-5759
Country	:	US
Telephone Number	:	773-784-8102
Fax Number	:	847-215-0240

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

Provider Enumeration Date	:	06/11/2005
Last Update Date	:	07/30/2007

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Directions to “ DR. PETER A HANCOCK DPM” Practice Location

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