Provider Demographics
NPI:1316553605
Name:PODIATRIC MANAGEMENT SYSTEMS LLC
Entity Type:Organization
Organization Name:PODIATRIC MANAGEMENT SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CHARNOTA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-540-9949
Mailing Address - Street 1:70 E LAKE ST STE 1102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7499
Mailing Address - Country:US
Mailing Address - Phone:312-372-1160
Mailing Address - Fax:312-372-3346
Practice Address - Street 1:7126 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2234
Practice Address - Country:US
Practice Address - Phone:847-673-1818
Practice Address - Fax:847-673-2639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty