Healther Providers Data Logo


Provider Type Icon

BEVERLY PODIATRY CENTER LLC NPI 1316117211


NPI Information

NPI: 1316117211
Provider Name: BEVERLY PODIATRY CENTER, LLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
9501 W 144TH PL
106
ORLAND PARK, IL
ZIP 60462
Phone: (708) 403-3668
Get Directions

BEVERLY PODIATRY CENTER, LLC is a foot and ankle surgery podiatrist in Orland Park, IL. BEVERLY PODIATRY CENTER, LLC NPI is 1316117211. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

9501 W 144TH PL
106
ORLAND PARK, IL
ZIP 60462-561
Phone: (708) 403-3668
Fax: (708) 403-3684

The provider's authorized official is Fortunee Massuda .
The authorized official title is Medical Director/ceo and has the following contact phone number (773) 752-2111.

The enumeration date for this NPI number is 3/6/2008 and was last updated on 12/17/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0131XPodiatristFoot SurgeryILLINOISNo
2213ES0103XPodiatristFoot & Ankle SurgeryILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
101619093OTHERILLINOISBLUE CROSS BLUE SHIELD
20852850007MEDICARE NSC
3658392MEDICARE PINILLINOIS
4CL8661MEDICARE PIN
51316117211MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
Remove or sync iconNPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI
Next NPI »