HYDE PARK PODIATRY CTR LTD NPI 1447242862

NPI Information

NPI: 1447242862
Provider Name: HYDE PARK PODIATRY CTR LTD
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1644 E 53RD ST
CHICAGO, IL
ZIP 60615
Phone: (773) 752-2111
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HYDE PARK PODIATRY CTR LTD is a foot and ankle surgery podiatrist in Chicago, IL. HYDE PARK PODIATRY CTR LTD NPI is 1447242862. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1644 E 53RD ST
CHICAGO, IL
ZIP 60615-210
Phone: (773) 752-2111
Fax: (773) 233-6703

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 8/22/2005 and was last updated on 3/23/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	213E00000X	Podiatrist		ILLINOIS	No
2	213ES0131X	Podiatrist	Foot Surgery	ILLINOIS	No
3	213EP1101X	Podiatrist	Primary Podiatric Medicine	ILLINOIS	No
4	213EP0504X	Podiatrist	Public Medicine	ILLINOIS	No
5	213ES0103X	Podiatrist	Foot & Ankle Surgery	ILLINOIS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CI12485	MEDICARE PIN
2	1447242862	MEDICARE PIN	ILLINOIS
3	658393	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
4	0852860002	MEDICARE NSC	ILLINOIS
5	600-15187	OTHER	ILLINOIS	BCBS
6	658393	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	MEDICARE

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

NPI Synchronization or Removal

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