Healthcare Provider Details

I. General information

NPI: 1558665869
Provider Name (Legal Business Name): ELIZABETH PACOCHA DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BIESTERFIELD RD STE 4001
ELK GROVE VILLAGE IL
60007-3371
US

IV. Provider business mailing address

602 KINGSBRIDGE DR
CAROL STREAM IL
60188-4320
US

V. Phone/Fax

Practice location:
  • Phone: 847-398-9999
  • Fax: 866-988-6323
Mailing address:
  • Phone: 847-398-9999
  • Fax: 866-988-6323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016005329
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH PACOCHA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 847-398-9999