Provider Demographics
NPI:1083905046
Name:MICHAEL A SCHWARTZMAN, DPM, LTD
Entity Type:Organization
Organization Name:MICHAEL A SCHWARTZMAN, DPM, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHWARTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-978-4344
Mailing Address - Street 1:1104 119TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1515
Mailing Address - Country:US
Mailing Address - Phone:773-978-4344
Mailing Address - Fax:
Practice Address - Street 1:1104 119TH ST
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1515
Practice Address - Country:US
Practice Address - Phone:773-978-4344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003402213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL691055Medicare PIN