MICHIGAN AVE PODIATRY LLC 1 NPI 1881026185

NPI Information

NPI: 1881026185
Provider Name: MICHIGAN AVE PODIATRY LLC 1
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
30 N MICHIGAN AVE
SUITE 720
CHICAGO, IL
ZIP 60602
Phone: (312) 701-0770
Get Directions

MICHIGAN AVE PODIATRY LLC 1 is a foot and ankle surgery podiatrist in Chicago, IL. MICHIGAN AVE PODIATRY LLC 1 NPI is 1881026185. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

30 N MICHIGAN AVE
SUITE 720
CHICAGO, IL
ZIP 60602-809
Phone: (312) 701-0770
Fax: (312) 701-0705

The provider's authorized official is Pam A Eernisse .
The authorized official title is Stockholder and has the following contact phone number (312) 701-0770.

The enumeration date for this NPI number is 8/8/2013 and was last updated on 8/26/2015.

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	213ES0103X	Podiatrist	Foot & Ankle Surgery	016004918	ILLINOIS	Yes

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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