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Organization

PODOMEDIK CLINICS LLC.

Active
Other names
Gerardo Perez Single Member
Organization subpart
No

Provider details

NPI number
Authorized official
GERARDO PEREZ ESPINDOLA DPM (OWNER/PROVIDER)
(414) 719-4799
Entity
Organization

Contact information

Practice address
159 N GREENLEAF ST STE 1, GURNEE, IL 60031-3341
(847) 249-3888
(847) 574-7477
Mailing address
159 N GREENLEAF ST STE 1, GURNEE, IL 60031-3341
(847) 249-3888
(847) 574-7477

Taxonomy

Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
016005265
IL
261QP1100X
Podiatric Clinic/Center
91125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016005265
IL
01
1932454279
GROUP NPI
WI
05
43241500
WI
01
IL4062
MEDICARE PTAN
IL
01
WI1874
MEDICARE PTAN
WI
Enumeration date
07/23/2012
Last updated
11/10/2023
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