institution
Gold Coast Podiatry Center, Llc
Foot Surgery Podiatrist in Evanston, Illinois
NPI 1154591048

Gold Coast Podiatry Center, Llc is a Foot Surgery Podiatrist based in Chicago, IL and is specialized in Foot Surgery. Gold Coast Podiatry Center, Llc practices in Evanston, IL. The NPI Number for Gold Coast Podiatry Center, Llc is 1154591048 and holds a License No. (Illinois).

The current practice location address for Gold Coast Podiatry Center, Llc is 1605 Chicago Ave, Evanston, IL and can be reached out via phone at 847-424-9888 and via fax at 847-424-9649.

Location: 1605 Chicago Ave, Evanston, IL, 60643-1810
institution
Provider Profile Details
NPI Number
1154591048
Provider Name
Gold Coast Podiatry Center, Llc
Credential
Provider Entity Type
Organization
Address
1605 Chicago Ave, Evanston, IL, 60643-1810
Phone Number
847-424-9888
Fax Number
847-424-9649
Provider Enumeration Date
03/06/2008
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01623607 01 IL BCBS
institution
Provider Business Practice Location Address Details
Address
1605 Chicago Ave
City
State
Zip
60201-4504
Phone Number
847-424-9888
Fax Number
847-424-9649
person
Provider Business Mailing Address Details
Address
1605 Chicago Ave
City
State
Zip
60201-4504
Phone Number
847-424-9888
Fax Number
847-424-9649
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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