Provider Demographics
NPI:1447218359
Name:DR BELA PANDIT PC
Entity Type:Organization
Organization Name:DR BELA PANDIT PC
Other - Org Name:PANDIT FOOT AND ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDIT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:312-523-4584
Mailing Address - Street 1:1325 S PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3830 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2004
Practice Address - Country:US
Practice Address - Phone:708-423-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005203213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016005203Medicaid
ILDF1014OtherRAILROAD MEDICARE
IL01635520OtherBCBS
ILDF1014OtherRAILROAD MEDICARE
IL01635520OtherBCBS