Provider Demographics
NPI:1780618397
Name:GINSBERG, RICK (DPM)
Entity type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:GINSBERG
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:PO BOX 825
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-0825
Mailing Address - Country:US
Mailing Address - Phone:847-239-4756
Mailing Address - Fax:847-239-6740
Practice Address - Street 1:1643 NORTHWIND BLVD
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-9613
Practice Address - Country:US
Practice Address - Phone:847-239-4756
Practice Address - Fax:847-239-6740
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005235213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist