MEDICARE: PODIATRY CENTER, SC

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	261QP1100X	Podiatric Clinic/Center

General Provider Information

NPI Number	:	1548381825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODIATRY CENTER, SC

Provider Business Mailing Address
First Line	:	30 N MICHIGAN AVE
Second Line	:	SUITE 1129
City	:	CHICAGO
State	:	IL
Zip	:	60602-3402
Country	:	US
Telephone Number	:	312-372-0919
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 N MICHIGAN AVE
Second Line	:	SUITE 1129
City	:	CHICAGO
State	:	IL
Zip	:	60602-3402
Country	:	US
Telephone Number	:	312-372-0919
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALISON DAWN TRAFFANSTEDT YOUNG
Credential	:	DPM
Telephone Number	:	312-372-0919

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	05/08/2023

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Directions to “PODIATRY CENTER, SC ” Practice Location

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