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Bart Wayne Gastwirth, DPM
Podiatrist in Champaign, Illinois
NPI 1568459030

Bart Wayne Gastwirth is a Podiatrist based in Urbana, IL. Bart Wayne Gastwirth practices in Champaign, IL and has the professional credentials of DPM. The NPI Number for Bart Wayne Gastwirth is 1568459030 and holds a License No. 016-002956 (Illinois).

The current practice location address for Bart Wayne Gastwirth is 1802 S Mattis Ave, Champaign, IL and can be reached out via phone at 217-383-3260 and via fax at 217-383-4459.

Location: 1802 S Mattis Ave, Champaign, IL, 61801-2529
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568459030
Provider Name
Bart Wayne Gastwirth
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
1802 S Mattis Ave, Champaign, IL, 61801-2529
Phone Number
217-383-3260
Fax Number
217-383-4459
Provider Enumeration Date
09/30/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
60001121 01 IL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1802 S Mattis Ave
City
Champaign
State
Illinois
Zip
61821-5923
Phone Number
217-383-3260
Fax Number
217-383-4459
person
Provider Business Mailing Address Details
Address
1802 S Mattis Ave
City
Champaign
State
Illinois
Zip
61821-5923
Phone Number
217-383-3260
Fax Number
217-383-4459
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
016-0002956 (Illinois)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
213EP1101X
License No.
016-002956 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Radiology
Taxonomy
213ER0200X
License No.
016-0002956 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Sports Medicine
Taxonomy
213ES0000X
License No.
016-002956 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
213ES0131X
License No.
016-002956 (Illinois)
Definition
Definition to come...
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