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
7250 ARTHUR BLVD, MERRILLVILLE, IN 46410-3766
(219) 736-2900
Mailing address
9933 S WESTERN AVE, SUITE 102, CHICAGO, IL 60643-1810
(773) 233-3800
(773) 233-2513
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
Primary
—
IN
213E00000X
Podiatrist
—
IN
213EP0504X
Public Medicine Podiatrist
—
IN
213EP1101X
Primary Podiatric Medicine Podiatrist
—
IN
213ER0200X
Radiology Podiatrist
—
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
—
IN
213ES0131X
Foot Surgery Podiatrist
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5007670004
DMEPOS
IN
01
—
90001145
BCBS OF IL # FOR IND
IN
Enumeration date
06/25/2007
Last updated
09/11/2025
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