Individual
DR. MICHAEL GEORGE LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
333 W 89TH AVE STE W5, MERRILLVILLE, IN 46410-7050
(219) 662-2279
(855) 742-9438
Mailing address
25 E SCHAUMBURG RD, STE 110, SCHAUMBURG, IL 60194-3548
(847) 352-1473
(847) 352-1479
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005210
IL
213EP0504X
Public Medicine Podiatrist
016005210
IL
213EP1101X
Primary Podiatric Medicine Podiatrist
016005210
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005210
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
07001055A
IN
213ES0131X
Foot Surgery Podiatrist
016005210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002490663 05
UNITED HEALTHCARE
IL
01
—
0007131702
AETNA
IL
05
—
200901510
—
IN
Enumeration date
06/24/2005
Last updated
04/21/2022
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