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General NPI Number Information
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NPI Number | 1275467052
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Entity Type | Organization
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Legal Business Name | MJT PODIATRY SC
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 2333 N HARLEM AVE
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City | CHICAGO
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State | IL
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Zip | 60707-2718
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Country | US
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Telephone | 224-328-6466
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Fax | 224-326-0567
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Provider Business Mailing Address
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Address Line | 2333 N HARLEM AVE
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City | CHICAGO
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State | IL
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Zip | 60707-2718
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Country | US
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Telephone | 224-328-6466
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Fax | 224-326-0567
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL JAMES TAGGE
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Credential | DPM
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Telephone | 224-328-6466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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