Provider Demographics
NPI:1770637886
Name:LOHEIDE, STEVEN P (DPM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:LOHEIDE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 PENNY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-1458
Mailing Address - Country:US
Mailing Address - Phone:847-426-2333
Mailing Address - Fax:
Practice Address - Street 1:210 PENNY AVE
Practice Address - Street 2:
Practice Address - City:EAST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1458
Practice Address - Country:US
Practice Address - Phone:847-426-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60100745OtherBCBS PROVIDER #
IL60100745OtherBCBS PROVIDER #