Provider Demographics
NPI:1588600605
Name:GINA E SIMS DPM PC
Entity Type:Organization
Organization Name:GINA E SIMS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-643-8400
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE 918
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:773-643-8400
Mailing Address - Fax:773-643-0430
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE 918
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:773-643-8400
Practice Address - Fax:773-643-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60001495OtherBCBS
ILDC8152OtherRAILROAD MEDICARE GROUP
IL0290810001Medicare NSC
IL60001495OtherBCBS