Provider Demographics
NPI:1669587069
Name:BEAUPIED, JOHN PAUL (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:BEAUPIED
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:6420 W 127TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2297
Mailing Address - Country:US
Mailing Address - Phone:708-371-2310
Mailing Address - Fax:708-371-9015
Practice Address - Street 1:6420 W 127TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2269
Practice Address - Country:US
Practice Address - Phone:708-371-2310
Practice Address - Fax:708-371-9015
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2010-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL016004181213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL480006720OtherRAIL ROAD MEDICARE NUMBER
IL016004181Medicaid
IL60001612OtherBLUE CROSS AND BLUE SHIEL
IL60001612OtherBLUE CROSS AND BLUE SHIEL
ILT38908Medicare UPIN
ILP15752Medicare PIN