Gold Coast Podiatry Center, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

GOLD COAST PODIATRY CENTER, LLC

Practice address

1605 Chicago Ave
Evanston, IL 60201-4504

Phone

(847) 424-9888

Fax

(847) 424-9649

NPI assigned

Mar 6, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Fortunee Massuda, DPM

Title

Medical Director/Ceo

Phone

(773) 752-2111

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1154591048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 S WESTERN AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431810",
            "telephone_number": "773-233-3800",
            "fax_number": "773-233-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014504",
            "telephone_number": "847-424-9888",
            "fax_number": "847-424-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST PODIATRY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "MASSUDA",
        "authorized_official_first_name": "FORTUNEE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/CEO",
        "authorized_official_telephone_number": "773-752-2111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01623607",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Gluck, PT
• Gnogno MD Visiting Physician Group Inc.
• Polly Godfrey, MD
• Diane Christine Goebel, MD
• Joseph Golbus, M.D.
• Kenneth N Goldberg, MD
• Lawrence Goldberg, MD
• Marla Goldberg, RPH
• Melissa D Goldberg, DPT
• Michael J. Goldberg, MD

• Foot & Ankle Surgery Podiatrist in Evanston, IL
• Providers in Evanston, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.