Provider Demographics
NPI:1831370477
Name:MARK E NEAMAND DPM PC
Entity type:Organization
Organization Name:MARK E NEAMAND DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEAMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM PC
Authorized Official - Phone:847-698-2895
Mailing Address - Street 1:621 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4732
Mailing Address - Country:US
Mailing Address - Phone:847-698-2895
Mailing Address - Fax:847-698-2942
Practice Address - Street 1:621 DEVON AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4732
Practice Address - Country:US
Practice Address - Phone:847-698-2895
Practice Address - Fax:847-698-2942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001626856OtherBLUE CROSS BLUE SHIELD
ILDC4413OtherRAILROAD MEDICARE GROUP NUMBER
ILT35527Medicare UPIN
IL0273860001Medicare NSC
IL001626856OtherBLUE CROSS BLUE SHIELD
IL203029Medicare PIN
ILU82665Medicare UPIN