Provider Demographics
NPI:1649463589
Name:A STEP AHEAD FOOTCARE, PC
Entity type:Organization
Organization Name:A STEP AHEAD FOOTCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BART
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-257-9000
Mailing Address - Street 1:15531 E 127TH ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8555
Mailing Address - Country:US
Mailing Address - Phone:630-257-9000
Mailing Address - Fax:630-257-9399
Practice Address - Street 1:15531 E 127TH ST
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-8555
Practice Address - Country:US
Practice Address - Phone:630-257-9000
Practice Address - Fax:630-257-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60000990OtherBCBS OF IL
IL573580Medicare PIN
IL60000990OtherBCBS OF IL