Healthcare Provider Details

I. General information

NPI: 1346172582
Provider Name (Legal Business Name): MICHAEL ALEJANDRO RACINES DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S DAMEN AVE
CHICAGO IL
60612-3728
US

IV. Provider business mailing address

4180 LUDINGTON CT
HOFFMAN ESTATES IL
60192-1728
US

V. Phone/Fax

Practice location:
  • Phone: 312-569-8387
  • Fax:
Mailing address:
  • Phone: 773-383-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1234
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: