Organization
NORTHWEST INDIANA PODIATRY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FORTUNEE MASSUDA DPM (MEDICAL DIRECTOR & CEO)
(773) 233-3800
Entity
Organization
Contact information
Practice address
3100 45TH AVE, HIGHLAND, IN 46322
(219) 922-0510
(219) 923-4594
Mailing address
9933 S WESTERN AVE, SUITE 102, CHICAGO, IL 60643-1810
(773) 445-3800
(773) 233-2513
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
—
—
213E00000X
Podiatrist
—
IN
213EP0504X
Public Medicine Podiatrist
—
—
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ER0200X
Radiology Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200124730C
—
IN
01
—
90001145
BCBS NUMBER
IN
Enumeration date
06/26/2007
Last updated
11/12/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us