EDGEWATER BEACH FOOT AND ANKLE CENTER P.C. NPI 1780801548

NPI Information

NPI: 1780801548
Provider Name: EDGEWATER BEACH FOOT AND ANKLE CENTER, P.C.
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
5331 N SHERIDAN RD
CHICAGO, IL
ZIP 60640
Phone: (773) 271-0807
Get Directions

EDGEWATER BEACH FOOT AND ANKLE CENTER, P.C. is a primary podiatric medicine podiatrist in Chicago, IL. EDGEWATER BEACH FOOT AND ANKLE CENTER, P.C. NPI is 1780801548. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5331 N SHERIDAN RD
CHICAGO, IL
ZIP 60640-531
Phone: (773) 271-0807
Fax: (484) 723-7350

The provider's authorized official is Benita J Kapnick .
The authorized official title is Office Manager and has the following contact phone number (773) 271-0807.

The enumeration date for this NPI number is 4/20/2007 and was last updated on 7/27/2020.

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 Number	License State	Primary
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	016002871	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	60000959	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD
2	016002871	MEDICAID	ILLINOIS
3	480021114	OTHER	ILLINOIS	MEDICARE PALMETTO

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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