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NPI Code Detail

MEDICARE: PODIATRIC MANAGEMENT SYSTEMS LLC

MEDICARE: PODIATRIC MANAGEMENT SYSTEMS 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
1213E00000XPodiatrist

General Provider Information

NPI Number : 1447866033
Entity Type Code : Organization
Provider Name (Legal Business Name) : PODIATRIC MANAGEMENT SYSTEMS LLC
Provider Business Mailing Address
First Line : 70 E LAKE ST STE 1102
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7499
Country : US
Telephone Number : 312-372-1160
Fax Number : 312-372-3346
Provider Business Practice Location Address
First Line : 9230 BROADWAY AVE
Second Line :
City : BROOKFIELD
State : IL
Zip : 60513-1252
Country : US
Telephone Number : 773-284-8811
Fax Number : 773-284-6431
Authorized Official
Title or Position : PRESIDENT
Name : DAVID ANTHONY CHARNOTA
Credential : DPM
Telephone Number : 847-540-9949
Provider Enumeration Date : 09/18/2020
Last Update Date : 09/18/2020

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Directions to “PODIATRIC MANAGEMENT SYSTEMS LLC ” Practice Location

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