LOGAN SQUARE FOOT CENTER NPI 1841389830

NPI Information

NPI: 1841389830
Provider Name: LOGAN SQUARE FOOT CENTER
Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

CLIA Number: 14D0724414

Address:
2831 N MILWAUKEE AVE.
CHICAGO, IL
ZIP 60618
Phone: (773) 772-4440
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LOGAN SQUARE FOOT CENTER is a podiatric clinic center in Chicago, IL. LOGAN SQUARE FOOT CENTER NPI is 1841389830. The provider is registered as an organization entity type.

The provider's business location address is:

2831 N MILWAUKEE AVE.
CHICAGO, IL
ZIP 60618-403
Phone: (773) 772-4440
Fax: (773) 772-4461

The provider's authorized official is Garry S Isenstadt .
The authorized official title is Director and has the following contact phone number (773) 772-4440.

The CLIA number assigned to this NPI record is 14D0724414 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 8/22/2020.

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	261QP1100X	Clinic/Center	Podiatric		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: 11/14/2023

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