Peachtree Podiatry LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016005323 Issued in IL

Legal business name

PEACHTREE PODIATRY LLC

Practice address

3534 W Palmer St Apt 2
Chicago, IL 60647-5699

Phone

(773) 372-1191

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Andrea L Peach, M D

Title

President

Phone

(773) 372-1191

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1639440944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 W PALMER ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475699",
            "telephone_number": "773-372-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3534 W PALMER ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475699",
            "telephone_number": "773-372-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "PEACH",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-372-1191",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "016005323",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peach Coast Therapy LLC
• Andrea Luisa Peach, DPM
• Richard Kevin Peach, PH.D.
• Peachey Psychotherapy PLLC
• Samantha Adams Peachey
• Dennis Alan Peacock, MD
• Edmund Thomas Peacock, MD
• Garrett Connor Peacy, RDN
• Kirstin Peahl, COMS, DTO&M
• Peak Counseling LLC

• Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.