LAKE SHORE PODIATRY CENTER, LLC
NPI 1366434706
Podiatrist - Foot & Ankle Surgery in Chicago, IL

Active since August 22, 2005
2511 N KEDZIE BLVD, 2ND FLOOR, CHICAGO, IL 60647(773) 342-5850(773) 489-7729 Get Directions Write a Review

NPPES record last updated: July 3, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lake Shore Podiatry Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SHORE PODIATRY CENTER, LLC (NPI 1366434706) is a healthcare organization registered as a foot & ankle surgery in Chicago, Illinois and active in the NPI registry since August 2005. The organization lists Fortunee Massuda, Medical Director/ceo, as its authorized official.

NPPES Registry Identity

NPI1366434706
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameLAKE SHORE PODIATRY CENTER, LLC
Location Address2511 N KEDZIE BLVD, 2ND FLOORChicago, IL 60647-2634
Mailing Address9933 S Western Ave, Suite 102Chicago, IL 60643-1810 · (773) 233-3800 · Fax (773) 233-2513
Fax(773) 489-7729
Organization SubpartNo
Authorized OfficialFortunee MassudaMedical Director/ceo · (773) 342-5850
Enumeration DateAugust 22, 2005
Last NPPES UpdateJuly 3, 2008
NPI 1366434706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
Also ListedPodiatristTaxonomy 213E00000X
Also ListedPodiatrist · Public MedicineTaxonomy 213EP0504X
Also ListedPodiatrist · Primary Podiatric MedicineTaxonomy 213EP1101X
Also ListedPodiatrist · Foot SurgeryTaxonomy 213ES0131X
2511 N KEDZIE BLVD, Chicago, IL 60647

Other Identifiers 4

Medicare ID-Type Unspecified530120IL · Medicare
Medicare NSC1366434706IL
Medicare PINCH4911
Other216-22095IL · Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
2511 N KEDZIE BLVD
CHICAGO, IL 60647
Family Medicine
2511 N KEDZIE BLVD
CHICAGO, IL 60647
Internal Medicine
2511 N KEDZIE BLVD
CHICAGO, IL 60647
Family Medicine
2511 N KEDZIE BLVD
CHICAGO, IL 60647
Family Medicine
2511 N KEDZIE BLVD
CHICAGO, IL 60647
Physical Therapist
2511 N KEDZIE BLVD
CHICAGO, IL 60647
Podiatrist (Foot & Ankle Surgery)
2511 N KEDZIE BLVD, 2ND FLOOR
CHICAGO, IL 60647
Physical Therapist
2511 N KEDZIE BLVD
CHICAGO, IL 60647

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Shore Podiatry Center, LLC's NPI number?

The NPI number for Lake Shore Podiatry Center, LLC is 1366434706. It was assigned to this organization in the NPPES registry on August 22, 2005.

Where is Lake Shore Podiatry Center, LLC located?

Lake Shore Podiatry Center, LLC is located at 2511 N Kedzie Blvd 2nd Floor, Chicago, IL 60647. The listed phone number is (773) 342-5850.

What is Lake Shore Podiatry Center, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Lake Shore Podiatry Center, LLC was last updated on July 3, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.