Organization · Type 2 NPI

Lake Shore Foot & Ankle, PC

Foot & Ankle Surgery Podiatrist · Highland Park, IL

NPI number 1114179215 Active

Practice location

767 Park Ave W, Suite 130
Highland Park, IL 60035-2400

Mailing address

2623 N Halsted St
Chicago, IL 60614-2393

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103X016004996 (IL)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1114179215

Lake Shore Foot & Ankle, PC's National Provider Identifier is 1114179215, issued on Oct 21, 2008. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Highland Park, IL. The record was last updated on Apr 30, 2015.