Provider Demographics
NPI:1720111024
Name:INSTEP PODIATRY, P.C.
Entity Type:Organization
Organization Name:INSTEP PODIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-462-1470
Mailing Address - Street 1:200 E WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5463
Mailing Address - Country:US
Mailing Address - Phone:630-462-1470
Mailing Address - Fax:630-462-9223
Practice Address - Street 1:200 E WILLOW AVE
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5463
Practice Address - Country:US
Practice Address - Phone:630-462-1470
Practice Address - Fax:630-462-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60001140OtherBCBS PROVIDER NUMBER
IL1152430001Medicare NSC
IL60001140OtherBCBS PROVIDER NUMBER