Provider Demographics
NPI:1841727195
Name:IN STRIDE FOOT CLINIC
Entity type:Organization
Organization Name:IN STRIDE FOOT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LALIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:219-808-0479
Mailing Address - Street 1:7800 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-808-0479
Mailing Address - Fax:
Practice Address - Street 1:1190 DRESDEN DR
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-6019
Practice Address - Country:US
Practice Address - Phone:708-502-3856
Practice Address - Fax:708-502-3856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000734A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty