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NPI Code Detail

MEDICARE: CHICAGO PODIATRIC SURGEONS PC

MEDICARE: CHICAGO PODIATRIC SURGEONS 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
1213E00000XPodiatrist16005134IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
160010789OTHERBCBS

General Provider Information

NPI Number : 1588658256
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHICAGO PODIATRIC SURGEONS PC
Provider Business Mailing Address
First Line : 467 W ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5704
Country : US
Telephone Number : 312-337-9900
Fax Number : 312-337-9902
Provider Business Practice Location Address
First Line : 467 W ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5704
Country : US
Telephone Number : 312-337-9900
Fax Number : 312-337-9902
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MRS. ELLEN CARR
Credential :
Telephone Number : 312-337-9900
Provider Enumeration Date : 09/08/2005
Last Update Date : 04/30/2015

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Directions to “CHICAGO PODIATRIC SURGEONS PC ” Practice Location

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