Provider Demographics
NPI:1417116609
Name:ALAMEDA FOOT CENTERS, PC
Entity Type:Organization
Organization Name:ALAMEDA FOOT CENTERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMEDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PODIATRY
Authorized Official - Phone:773-296-3900
Mailing Address - Street 1:3000 N HALSTED ST
Mailing Address - Street 2:SUITE 611
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5188
Mailing Address - Country:US
Mailing Address - Phone:773-296-3900
Mailing Address - Fax:773-296-3901
Practice Address - Street 1:3000 N HALSTED ST
Practice Address - Street 2:SUITE 611
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5188
Practice Address - Country:US
Practice Address - Phone:773-296-3900
Practice Address - Fax:773-296-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003617213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty