MEDICARE: DR. JAMES G ELIPAS D.P.M.

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	0160031091	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	648120	OTHER	IL	MEDICARE INDIVIDUAL NUMBE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60001157	OTHER	IL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851389761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES G ELIPAS D.P.M.

Provider Business Mailing Address
First Line	:	6304 N NAGLE AVE
Second Line	:	1ST FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60646-3614
Country	:	US
Telephone Number	:	773-853-0081
Fax Number	:	773-853-2970

Provider Business Practice Location Address
First Line	:	6304 N NAGLE AVE
Second Line	:	1ST FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60646-3614
Country	:	US
Telephone Number	:	773-853-0081
Fax Number	:	773-853-2970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	02/02/2016

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