EDGEWATER BEACH FOOT AND ANKLE CENTER, P.C. (NPI# 1780801548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780801548 |
| Entity Type | Organization |
| Organization Name | EDGEWATER BEACH FOOT AND ANKLE CENTER, P.C. |
| Practice Address |
5331 N Sheridan Rd Chicago IL 60640-2531 |
| Mailing Address |
800 Austin St Ste 508 Evanston IL 60202-3445 |
| Practice Telephone | 7732710807 |
| Practice Fax Number | 4847237350 |
| Mailing Telephone | 7732710807 |
| Mailing Fax Number | 4847237350 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-07-27 |
| Authorized Official Name | MS. BENITA J KAPNICK (OFFICE MANAGER) |
| Authorized Official Telephone | 7732710807 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
016002871 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 60000959 | 01 |
| IL | 016002871 | 05 | |
| IL | MEDICARE PALMETTO | 480021114 | 01 |
| Street Address |
5331 N SHERIDAN RD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-2531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952600058 | Magdala Danielle Lafontant | Podiatrist | 6374 N Lincoln Ave Ste 205, Chicago, IL 60659-1283 | 2011-03-15 |
| 1932285509 | Moeed Ekbal | Podiatrist | 2400 N Lakeview Ave Apt 2703, Chicago, IL 60614-2741 | 2006-10-27 |
| 1487677076 | David T Hong | Podiatrist | 180 W Washington St, Suite 930, Chicago, IL 60602-3580 | 2006-07-25 |
| 1952394751 | Johnny Dan Parker | Podiatrist | 8601 S Cottage Grove Ave, Chicago, IL 60619-6107 | 2005-08-26 |
| 1669478640 | Andrew Benedict O'keefe Jr. | Podiatrist | 6374 N Lincoln Ave, Ste 314, Chicago, IL 60659-1275 | 2005-06-23 |
| 1679197644 | Corey Czarnecki | Podiatrist | 5140 N California Ave, Chicago, IL 60625-3645 | 2020-06-04 |
| 1497152516 | My Doctor P C | Podiatrist | 2811 W Greenleaf Ave, Chicago, IL 60645-2913 | 2014-12-04 |
| 1851729370 | Midwest Podiatric Physicians, P.C. | Podiatrist | 1229 N North Branch St, Ste 308, Chicago, IL 60642-2473 | 2013-10-18 |
| 1194062661 | Dr. Kaye Lagdaan, P.C. | Podiatrist | 4112 N Lincoln Ave, Chicago, IL 60618-3028 | 2013-01-03 |
| 1205194156 | Ross Wayne Green | Podiatrist | 3631 N Harlem Ave, Chicago, IL 60634-2237 | 2012-04-29 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.