MEDICARE: GINA E SIMS DPM PC

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	213ES0103X	Foot & Ankle Surgery Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DC8152	OTHER	IL	RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60001495	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1588600605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINA E SIMS DPM PC

Provider Business Mailing Address
First Line	:	1525 E 53RD ST
Second Line	:	SUITE 918
City	:	CHICAGO
State	:	IL
Zip	:	60615-4557
Country	:	US
Telephone Number	:	773-643-8400
Fax Number	:	773-643-0430

Provider Business Practice Location Address
First Line	:	1525 E 53RD ST
Second Line	:	SUITE 918
City	:	CHICAGO
State	:	IL
Zip	:	60615-4557
Country	:	US
Telephone Number	:	773-643-8400
Fax Number	:	773-643-0430

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GINA E SIMS
Credential	:	DPM
Telephone Number	:	773-643-8400

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	04/30/2015

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Directions to “GINA E SIMS DPM PC ” Practice Location

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