Pietz, Mark

Pietz, Mark is an individual health care provider with primary practice located at 3000 N Halsted St Suite 821, Chicago IL 60657-5188. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Pietz, Mark can be contacted via phone (773) 296-7160.

Contact Information

Primary practice address
3000 N Halsted St Suite 821 Chicago IL 60657-5188
Phone: (773) 296-7160
Fax: (773) 296-3440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016003670 Illinois

Profile Details

NPI number 1053310482
LBN Legal business name Pietz, Mark
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Oct 28th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053310482 NPPES
Illinois MEDICAID 016003670
Illinois Other 1623520

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