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NPI Code Detail

MEDICARE: LAURA JANINE PICKARD DPM

MEDICARE: LAURA JANINE PICKARD DPM
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
1213E00000XPodiatrist016004430IL
2213E00000XPodiatrist2017000763MO

General Provider Information

NPI Number : 1760433734
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA JANINE PICKARD DPM
Provider Business Mailing Address
First Line : 7325 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60634-3547
Country : US
Telephone Number : 773-625-2211
Fax Number : 773-625-2255
Provider Business Practice Location Address
First Line : 303 N KEENE ST
Second Line : STE 301
City : COLUMBIA
State : MO
Zip : 65201-8053
Country : US
Telephone Number : 573-882-8000
Fax Number : 573-882-6600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 08/02/2023

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Directions to “ LAURA JANINE PICKARD DPM” Practice Location

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