Provider Demographics
NPI:1235238155
Name:HILTZIK, DAVID BRIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:HILTZIK
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 1:1720 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-3502
Mailing Address - Country:US
Mailing Address - Phone:847-336-3338
Mailing Address - Fax:847-336-0683
Practice Address - Street 1:1121 W GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60087-4919
Practice Address - Country:US
Practice Address - Phone:847-336-3338
Practice Address - Fax:847-336-0683
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004380213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT93297Medicare UPIN
IL207208Medicare ID - Type Unspecified