MEDICARE: ANIE A CHERIAN 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	2305	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013981448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIE A CHERIAN D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 917
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60065-0917
Country	:	US
Telephone Number	:	847-504-5000
Fax Number	:	847-504-5015

Provider Business Practice Location Address
First Line	:	180 COUNTY ROAD 300
Second Line	:
City	:	JOURDANTON
State	:	TX
Zip	:	78026
Country	:	US
Telephone Number	:	847-504-5000
Fax Number	:	847-504-5015

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	05/22/2019

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Directions to “ ANIE A CHERIAN D.P.M.” Practice Location

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