Individual
DR. MACKENZI J. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M
Contact information
Practice address
225 W WASHINGTON ST STE 1500, CHICAGO, IL 60606-3485
(847) 504-5000
(847) 504-5015
Mailing address
225 W WASHINGTON ST STE 1500, CHICAGO, IL 60606-3485
(847) 504-5000
(847) 504-5015
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001100A
IN
213E00000X
Podiatrist
99040479A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
LL9464
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199966717
—
AR
01
—
P01242897
RAILROAD MEDICARE
AR
Enumeration date
01/28/2008
Last updated
11/17/2025
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