Provider Demographics
NPI:1083829899
Name:SILVERBLATT, MANUEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:SILVERBLATT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7355 N KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1806
Mailing Address - Country:US
Mailing Address - Phone:773-281-1691
Mailing Address - Fax:
Practice Address - Street 1:7355 N KENNETH AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1806
Practice Address - Country:US
Practice Address - Phone:773-281-1691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL162394213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016002394Medicaid
IL519280Medicare ID - Type Unspecified