LAKE SHORE PODIATRY CENTER LLC CHICAGO, IL

Contact Information

LAKE SHORE PODIATRY CENTER, LLC

4733 N DAMEN AVE
CHICAGO, IL 60625-1442

Phone: 773-871-2250
Fax: 773-697-0134
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Surgery, Foot & Ankle	213ES0103X	48	Podiatry
Podiatrist	213E00000X	48	Podiatry
Primary Podiatric Medicine	213EP1101X	48	Podiatry
Public Health	213EP0504X	48	Podiatry
Surgery, Foot	213ES0131X	48	Podiatry

Indicates primary specialty

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NPI Profile & details for LAKE SHORE PODIATRY CENTER LLC · (Female)

NPI #	`1366548018`
Status	Active
Credentials
Entity	Individual
Enumeration date	09/16/2006
Last updated	07/17/2008 - About 18 years ago
Sole proprietor ¹	Not specified
Identifiers	IL Other 216-22095 BCBS
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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