Provider Demographics
NPI:1548397607
Name:STEVEN B OVERPECK DPM PC
Entity Type:Organization
Organization Name:STEVEN B OVERPECK DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:OVERPECK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:815-730-8200
Mailing Address - Street 1:1100 ESSINGTON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8425
Mailing Address - Country:US
Mailing Address - Phone:815-730-8200
Mailing Address - Fax:815-730-8360
Practice Address - Street 1:1100 ESSINGTON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8425
Practice Address - Country:US
Practice Address - Phone:815-730-8200
Practice Address - Fax:815-730-8360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932510OtherBCBS
ILDO5883OtherRAILROAD MEDICARE
IL9932510OtherBCBS
IL5858340001Medicare NSC