Lake Shore Podiatry Center, Llc

LBN: Lake Shore Podiatry Center, Llc
Lake Shore Podiatry Center, Llc is an health care organization with primary practice located at 4733 N Damen Ave , Chicago IL 60625-1442. The organization recently has 5 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Public Medicine, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, 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. Lake Shore Podiatry Center, Llc can be contacted via phone (773) 871-2250, or through Massuda, Fortunee via phone (773) 233-3800.

Contact Information

Primary practice address
4733 N Damen Ave Chicago IL 60625-1442
Phone: (773) 871-2250
Fax: (773) 697-0134
Website:
Map and Directions
Authorized official contact:
Name: Massuda, Fortunee Doctor of Podiatric Medicine (DPM)
Phone: (773) 233-3800

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X Illinois
Podiatric Medicine & Surgery Service Providers / Public Medicine 213EP0504X Illinois
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X Illinois
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X Illinois
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X Illinois

Profile Details

NPI number 1366548018
LBN Legal business name Lake Shore Podiatry Center, Llc
DBA Doing business as
Authorized official Massuda, Fortunee Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 16th, 2006
Last updated Jul 17th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366548018 NPPES
Illinois Other 216-22095 BCBS

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