Provider Demographics
NPI:1740392224
Name:SPITZ, ANTHONY (DPM PC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:SPITZ
Suffix:
Gender:M
Credentials:DPM PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N WOLF RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-3027
Mailing Address - Country:US
Mailing Address - Phone:847-465-9311
Mailing Address - Fax:847-465-8233
Practice Address - Street 1:505 N WOLF RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3027
Practice Address - Country:US
Practice Address - Phone:847-465-9311
Practice Address - Fax:847-465-8233
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16004564213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004564Medicaid
IL0812580001Medicare NSC
IL016004564Medicaid
ILU19962Medicare UPIN