MEDICARE: DR. PETER B AKERELE D.P.M.

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	016003216	IL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	016003216	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	:	1609874015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER B AKERELE D.P.M.

Provider Business Mailing Address
First Line	:	175 N HARBOR DR
Second Line	:	STE 3906
City	:	CHICAGO
State	:	IL
Zip	:	60601-7344
Country	:	US
Telephone Number	:	312-961-6098
Fax Number	:	773-978-1568

Provider Business Practice Location Address
First Line	:	2223 E 79TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-5016
Country	:	US
Telephone Number	:	773-978-2100
Fax Number	:	773-978-1568

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

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	01/25/2010

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