Individual
DR. TODD M MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
18 CHICAGO AVE, OAK PARK, IL 60302
(773) 253-3933
(773) 437-6780
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005154
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
5325
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
892-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005154
—
IL
01
—
01634612
BLUE CROSS BLUE SHIELD
IL
05
—
43237200
—
WI
05
—
43267600
—
WI
Enumeration date
08/31/2006
Last updated
06/09/2025
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