LAKE SHORE PODIATRY CENTER, LLC
NPI 1679670905
Podiatrist in Chicago, IL

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

The NPI number for Lake Shore Podiatry Center, LLC is 1679670905. It was assigned to this organization in the NPPES registry on September 20, 2006.

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

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Active since September 20, 2006

2143 W WELLINGTON AVE, CHICAGO, IL 60618(773) 871-2250(773) 697-0134 Get Directions Write a Review

NPPES record last updated: February 14, 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 1679670905) is a healthcare organization registered as a podiatrist 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

NPI1679670905

Entity TypeOrganization

Primary Taxonomy213E00000X

Legal Business NameLAKE SHORE PODIATRY CENTER, LLC

Location Address2143 W WELLINGTON AVEChicago, IL 60618-8268

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) 233-0590

Enumeration DateSeptember 20, 2006

Last NPPES UpdateFebruary 14, 2008

✔ NPI 1679670905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

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.

Also ListedPodiatrist · Public MedicineTaxonomy 213EP0504X

Also ListedPodiatrist · Primary Podiatric MedicineTaxonomy 213EP1101X

Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X

Also ListedPodiatrist · Foot SurgeryTaxonomy 213ES0131X

2143 W WELLINGTON AVE, Chicago, IL 60618

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Other Identifiers 3

Medicare ID-Type Unspecified530120IL · Medicare Group Number

Medicare NSC4147780001IL

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 3

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

YIGAZU WELLNESS CLINIC S.C.

Internal Medicine

2143 W WELLINGTON AVE, SUITE 100
CHICAGO, IL 60618

Cook County (773) 528-8400

MANDIE MARTUZZO LPT

Physical Therapist

2143 W WELLINGTON AVE
CHICAGO, IL 60618

Cook County (773) 528-5400

NICOLE RUFFOLO

Acupuncturist

2143 W WELLINGTON AVE
CHICAGO, IL 60618

Cook County (915) 077-3227

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 1679670905. It was assigned to this organization in the NPPES registry on September 20, 2006.

Where is Lake Shore Podiatry Center, LLC located?

Lake Shore Podiatry Center, LLC is located at 2143 W Wellington Ave, Chicago, IL 60618. The listed phone number is (773) 871-2250.

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

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

When was this NPI record last updated?

The NPPES record for Lake Shore Podiatry Center, LLC was last updated on February 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.