DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: GOLD COAST PODIATRY CENTER, LLC

MEDICARE: GOLD COAST PODIATRY CENTER, LLC
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
1213ES0131XFoot Surgery PodiatristIL
2213ES0103XFoot & Ankle Surgery PodiatristIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101623607OTHERILBCBS

General Provider Information

NPI Number : 1154591048
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLD COAST PODIATRY CENTER, LLC
Provider Business Mailing Address
First Line : 9933 S WESTERN AVE
Second Line : SUITE 102
City : CHICAGO
State : IL
Zip : 60643-1810
Country : US
Telephone Number : 773-233-3800
Fax Number : 773-233-2513
Provider Business Practice Location Address
First Line : 1605 CHICAGO AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60201-4504
Country : US
Telephone Number : 847-424-9888
Fax Number : 847-424-9649
Authorized Official
Title or Position : MEDICAL DIRECTOR/CEO
Name : MRS. FORTUNEE MASSUDA
Credential : DPM
Telephone Number : 773-752-2111
Provider Enumeration Date : 03/06/2008
Last Update Date : 11/12/2009

Similar Medicare Providers

1043202559 — EVANSTON PODIATRY CENTER
Practice Location Address:
1605 CHICAGO AVE
EVANSTON, IL
60201-4504
Practice Phone: 847-424-9888
Practice Fax: 847-424-9649
1982613519 — DR. DOUGLAS JOSEPH MEYROSE PT
Practice Location Address:
1629 CHICAGO AVE
EVANSTON, IL
60201-4504
Practice Phone: 847-475-1630
Practice Fax: 847-475-1631
1043434871 — LEE DAVIMES P.T.
Practice Location Address:
1629 CHICAGO AVE
EVANSTON, IL
60201-4504
Practice Phone: 847-475-1630
Practice Fax: 847-475-1631
1093948960 — MISS LACEY MARIE WINTER DPT
Practice Location Address:
1629 CHICAGO AVE
EVANSTON, IL
60201-4504
Practice Phone: 847-475-1630
Practice Fax:
1487902938 — ABUNDANT TRANSFORMATION CO
Practice Location Address:
1609A CHICAGO AVE
EVANSTON, IL
60201-4504
Practice Phone: 847-869-1313
Practice Fax: 847-869-1717
1942740881 — KHALIAH YVONNE ELLISTON
Practice Location Address:
1629 CHICAGO AVE
EVANSTON, IL
60201-4504
Practice Phone: 773-297-1023
Practice Fax:

Directions to “GOLD COAST PODIATRY CENTER, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.