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BEVERLY PODIATRY CENTER, LLC
NPI 1790777118
Podiatrist - Foot & Ankle Surgery in Chicago, IL

Active since August 22, 2005
9933 S WESTERN AVE, SUITE 102, CHICAGO, IL 60643(773) 445-8700(773) 445-4646 Get Directions Write a Review

NPPES record last updated: November 12, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Beverly Podiatry Center, Llc NPPES

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

BEVERLY PODIATRY CENTER, LLC (NPI 1790777118) 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

NPI1790777118
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameBEVERLY PODIATRY CENTER, LLC
Location Address9933 S WESTERN AVE, SUITE 102Chicago, IL 60643-1810
Mailing Address9933 S Western Ave, Suite 102Chicago, IL 60643-1810 · (773) 445-8700 · Fax (773) 445-4646
Phone(773) 445-8700
Fax(773) 445-4646
Organization SubpartNo
Authorized OfficialFortunee MassudaMedical Director/ceo · (773) 445-8700
Enumeration DateAugust 22, 2005
Last NPPES UpdateNovember 12, 2009
✔ NPI 1790777118 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
9933 S WESTERN AVE, Chicago, IL 60643
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Other Identifiers 5

Other600-15186IL · Bcbs
Medicare PINCL7030
Medicare NSC0852850001IL
Medicare ID-Type Unspecified658392IL · Medicare
Medicare PIN1790777118IL

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 5

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

INSTITUTE OF FOOT & ANKLE RECONSTRUCTIVE SURGERY OF ILLINOIS
Podiatrist (Foot & Ankle Surgery)
9933 S WESTERN AVE, SUITE 102
CHICAGO, IL 60643
Cook County (773) 445-8700
JAVETTE C ORGAIN MD SC
Family Medicine
9933 S WESTERN AVE, EMB - SUITE 103
CHICAGO, IL 60643
Cook County (312) 833-1077
NEIL R. B. BONJE DDS
Dentist (Endodontics)
9933 S WESTERN AVE, SUITE 203
CHICAGO, IL 60643
Cook County (773) 779-3636
ENA M. GARDNER
Counselor (Mental Health)
9933 S WESTERN AVE
CHICAGO, IL 60643
Cook County (312) 504-9995
BEVERLY BEHAVIORAL HEALTH, LTD
Clinic/Center (Adult Mental Health)
9933 S WESTERN AVE, SUITE 104
CHICAGO, IL 60643
Cook County (773) 779-9700

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 Beverly Podiatry Center, LLC's NPI number?

The NPI number for Beverly Podiatry Center, LLC is 1790777118. It was assigned to this organization in the NPPES registry on August 22, 2005.

Where is Beverly Podiatry Center, LLC located?

Beverly Podiatry Center, LLC is located at 9933 S Western Ave Suite 102, Chicago, IL 60643. The listed phone number is (773) 445-8700.

What is Beverly 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 Beverly Podiatry Center, LLC was last updated on November 12, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.