MEDICARE: DR. MYRA HANDY 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	213E00000X	Podiatrist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001635155	OTHER	IL	BCBS
2	5271970001	OTHER		DMERC

General Provider Information

NPI Number	:	1447262597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRA HANDY DPM

Provider Business Mailing Address
First Line	:	PO BOX 496957
Second Line	:	2337 EAST 71ST STREET
City	:	CHICAGO
State	:	IL
Zip	:	60649
Country	:	US
Telephone Number	:	773-643-2250
Fax Number	:	773-643-4290

Provider Business Practice Location Address
First Line	:	2337 EAST 71ST STREET
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649
Country	:	US
Telephone Number	:	773-643-2250
Fax Number	:	773-643-4290

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

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MYRA HANDY DPM” Practice Location

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