Healthcare Provider Details

I. General information

NPI: 1952376147
Provider Name (Legal Business Name): STEVEN LEON GEARY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 6TH ST
GREAT LAKES IL
60088-2833
US

IV. Provider business mailing address

8406 207TH AVE
BRISTOL WI
53104-9153
US

V. Phone/Fax

Practice location:
  • Phone: 847-688-3995
  • Fax: 847-688-2327
Mailing address:
  • Phone: 262-857-7514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number811-025
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: