Individual
MARK PIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3000 N HALSTED ST, SUITE 821, CHICAGO, IL 60657-5188
(773) 296-7160
(773) 296-3440
Mailing address
3000 N HALSTED ST, SUITE 821, CHICAGO, IL 60657-5188
(773) 296-7160
(773) 296-3440
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003670
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016003670
—
IL
01
—
1623520
BCBS
IL
Enumeration date
07/18/2005
Last updated
10/28/2011
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