Provider Demographics
NPI:1851385553
Name:METZ, SLOAN V (DPM)
Entity Type:Individual
Prefix:DR
First Name:SLOAN
Middle Name:V
Last Name:METZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 W DIVERSEY PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1454
Mailing Address - Country:US
Mailing Address - Phone:773-542-5203
Mailing Address - Fax:773-542-5841
Practice Address - Street 1:3700 W 26TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3824
Practice Address - Country:US
Practice Address - Phone:773-542-5203
Practice Address - Fax:773-542-5841
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004617213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004617Medicaid
IL016-004617-4Medicaid
IL203244Medicare PIN
IL367830Medicare PIN
IL016004617Medicaid