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DEZANEK PODIATRY CENTER LTD NPI 1407934888


NPI Information

NPI: 1407934888
Provider Name: DEZANEK PODIATRY CENTER LTD

Doing Business As: ROBERT C DEZANEK DPM

Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
5916 W HIGGINS AVE
CHICAGO, IL
ZIP 60630
Phone: (773) 283-1911
Get Directions

DEZANEK PODIATRY CENTER LTD is a podiatrist in Chicago, IL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DEZANEK PODIATRY CENTER LTD NPI is 1407934888. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Robert C Dezanek Dpm.

The provider's business location address is:

5916 W HIGGINS AVE
CHICAGO, IL
ZIP 60630-905
Phone: (773) 283-1911

The provider's authorized official is Robert Charles Dezanek .
The authorized official title is Corp President and has the following contact phone number (773) 283-1911.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 12/26/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatrist016003970ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1T36759MEDICARE UPIN
2216578MEDICARE PINILLINOIS
3480009595OTHERILLINOISRAILROAD MEDICARE
40060001570OTHERILLINOISBLUE CROSS
53394649896063002MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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