Provider Demographics
NPI:1659883346
Name:HOME PODIATRY CARE, INC
Entity Type:Organization
Organization Name:HOME PODIATRY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAIN DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-673-9284
Mailing Address - Street 1:7620 W 159TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5400
Mailing Address - Country:US
Mailing Address - Phone:708-673-9284
Mailing Address - Fax:
Practice Address - Street 1:7620 W 159TH ST STE 105
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5400
Practice Address - Country:US
Practice Address - Phone:708-673-9284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty