MEDICARE: LAURA J PICKARD 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	213E00000X	Podiatrist		IL

General Provider Information

NPI Number	:	1821032103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA J PICKARD DPM PC

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	:	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

Authorized Official
Title or Position	:	OWNER
Name	:	LAURA J PICKARD
Credential	:	DPM
Telephone Number	:	773-625-2211

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	08/22/2020

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