GOLD COAST PODIATRY CENTER LLC NPI 1154591048

NPI Information

GOLD COAST PODIATRY CENTER, LLC is a foot and ankle surgery podiatrist in Evanston, IL. GOLD COAST PODIATRY CENTER, LLC NPI is 1154591048. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1605 CHICAGO AVE
EVANSTON, IL
ZIP 60201-504
Phone: (847) 424-9888
Fax: (847) 424-9649

The provider's authorized official is Fortunee Massuda .
The authorized official title is Medical Director/ceo and has the following contact phone number (773) 752-2111.

The enumeration date for this NPI number is 3/6/2008 and was last updated on 11/12/2009.

Taxonomy Codes

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