Organization
CHICAGO PODIATRIC SURGEONS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN CARR (PRACTICE MANAGER)
(312) 337-9900
Entity
Organization
Contact information
Practice address
467 W ERIE ST, CHICAGO, IL 60654-5704
(312) 337-9900
(312) 337-9902
Mailing address
467 W ERIE ST, CHICAGO, IL 60654-5704
(312) 337-9900
(312) 337-9902
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
16005134
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60010789
BCBS
—
Enumeration date
09/08/2005
Last updated
04/30/2015
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