Organization · Type 2 NPI

Lake Shore Podiatry Center, LLC

Foot & Ankle Surgery Podiatrist · Chicago, IL

NPI number 1366548018 Active

Practice location

4733 N Damen Ave
Chicago, IL 60625-1442

Fax (773) 697-0134

Mailing address

9933 S Western Ave, Suite 102
Chicago, IL 60643-1810

Specialties and licenses

TaxonomyCodeLicense
Podiatrist 213E00000XNone listed
Public Medicine Podiatrist 213EP0504XNone listed
Primary Podiatric Medicine Podiatrist 213EP1101XNone listed
Foot & Ankle Surgery Podiatrist Primary 213ES0103XNone listed
Foot Surgery Podiatrist 213ES0131XNone listed

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

6 other providers at this address

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About NPI 1366548018

Lake Shore Podiatry Center, LLC's National Provider Identifier is 1366548018, issued on Sep 16, 2006. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Chicago, IL. The record was last updated on Jul 17, 2008.