MEDICARE: LOGAN SQUARE FOOT CENTER

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	261QP1100X	Podiatric Clinic/Center		IL

General Provider Information

NPI Number	:	1841389830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOGAN SQUARE FOOT CENTER

Provider Business Mailing Address
First Line	:	2831 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7403
Country	:	US
Telephone Number	:	773-772-4440
Fax Number	:	773-772-4461

Provider Business Practice Location Address
First Line	:	2831 N MILWAUKEE AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7403
Country	:	US
Telephone Number	:	773-772-4440
Fax Number	:	773-772-4461

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. GARRY S ISENSTADT
Credential	:	D.P.M.
Telephone Number	:	773-772-4440

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1457306953 — ELY ROBERT TANDETER
Practice Location Address:

2837 N MILWAUKEE AVE
CHICAGO, IL
60618-7403

Practice Phone: 773-235-6266
Practice Fax:

1144275546 — SILVANA SHLIAPOCHNIK
Practice Location Address:

2837 N MILWAUKEE AVE
CHICAGO, IL
60618-7403

Practice Phone: 773-235-6266
Practice Fax: 773-235-9054

1952358574 — DR. GARRY S ISENSTADT D.P.M.
Practice Location Address:

2831 N MILWAUKEE AVE
CHICAGO, IL
60618-7403

Practice Phone: 773-772-4440
Practice Fax: 773-772-4461

1245278233 — KIMBALL MEDICAL CENTER SC
Practice Location Address:

2837 N MILWAUKEE AVE
CHICAGO, IL
60618-7403

Practice Phone: 773-235-6266
Practice Fax:

1760418024 — VITAL RX LLC
Practice Location Address:

2837 N MILWAUKEE AVE
CHICAGO, IL
60618-7403

Practice Phone: 773-862-1699
Practice Fax: 773-862-2350

1619166725 — DR. THEODORE MICHAEL SIEGEL D.D.S.
Practice Location Address:

2833 N MILWAUKEE AVE
CHICAGO, IL
60618-7403

Practice Phone: 773-772-8400
Practice Fax:

Directions to “LOGAN SQUARE FOOT CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.