Provider Demographics
NPI:1780696765
Name:VELARDE, JAMES D (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:VELARDE
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 1:165 N CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-2009
Mailing Address - Country:US
Mailing Address - Phone:630-705-9554
Mailing Address - Fax:
Practice Address - Street 1:165 N CHURCH RD
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-2009
Practice Address - Country:US
Practice Address - Phone:630-238-1111
Practice Address - Fax:630-238-0164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016003948213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016003948Medicaid
IL016003948Medicaid
ILU37926Medicare UPIN