Beverly Podiatry Center, Llc
LBN: Beverly Podiatry Center, Llc
Beverly Podiatry Center, Llc is an health care organization with primary practice located at 9501 W 144Th Pl 106, Orland Park IL 60462-2561. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is the primary health care specialty.
Beverly Podiatry Center, Llc can be contacted via phone (708) 403-3668, or through Massuda, Fortunee via phone (773) 752-2111.
Contact Information
Primary practice address
9501 W 144Th Pl 106
Orland Park IL 60462-2561
Phone: (708) 403-3668
Fax: (708) 403-3684
Website:
Authorized official contact:
Name: Massuda, Fortunee Doctor of Podiatric Medicine (DPM)
Phone: (773) 752-2111
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | Illinois | |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | Illinois |
Profile Details
| NPI number | 1316117211 |
|---|---|
| LBN Legal business name | Beverly Podiatry Center, Llc |
| DBA Doing business as | |
| Authorized official | Massuda, Fortunee Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 6th, 2008 |
| Last updated | Dec 17th, 2011 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316117211 | NPPES |
| Illinois | Other | 01619093 | BLUE CROSS BLUE SHIELD |
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