LAKE SHORE PODIATRY CENTER, LLC
NPI 1366548018
Podiatrist - Foot & Ankle Surgery in Chicago, IL

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

The NPI number for Lake Shore Podiatry Center, LLC is 1366548018. It was assigned to this organization in the NPPES registry on September 16, 2006.

Q: 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.

Active since September 16, 2006

4733 N DAMEN AVE, CHICAGO, IL 60625(773) 871-2250(773) 697-0134 Get Directions Write a Review

NPPES record last updated: July 17, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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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 1366548018) is a healthcare organization registered as a foot & ankle surgery in Chicago, Illinois and active in the NPI registry since September 2006. The organization lists Fortunee Massuda, Medical Director & Ceo, as its authorized official.

NPPES Registry Identity

NPI1366548018

Entity TypeOrganization

Primary Taxonomy213ES0103X

Legal Business NameLAKE SHORE PODIATRY CENTER, LLC

Location Address4733 N DAMEN AVEChicago, IL 60625-1442

Mailing Address9933 S Western Ave, Suite 102Chicago, IL 60643-1810 · (773) 233-3800 · Fax (773) 233-2513

Phone(773) 871-2250

Fax(773) 697-0134

Organization SubpartNo

Authorized OfficialFortunee MassudaMedical Director & Ceo · (773) 233-3800

Enumeration DateSeptember 16, 2006

Last NPPES UpdateJuly 17, 2008

✔ NPI 1366548018 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

4733 N DAMEN AVE, Chicago, IL 60625

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Other Identifiers 4

Medicare NSC1366548018IL

Medicare ID-Type Unspecified530120IL · Medicare Group Number

Other216-22095IL · Bcbs

Medicare PINCH2456IL

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 6

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

STRIEDINGER MEDICAL GROUP SC

Internal Medicine