NPIMap

Organization Active NPI

Lake Mi Mobile Doctors, P.C.

  • Primary Podiatric Medicine Podiatrist
  • Chicago, IL
National Provider Identifier
1992870281
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
LAKE MI MOBILE DOCTORS, P.C.
Practice address
3319 N Elston Ave
Suite 100
Chicago, IL 60618-5811
Phone
(773) 751-7200
Fax
(773) 583-4401
NPI assigned
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Mr. Tysyn Contreras
Title
Director, Quality Assurance
Phone
(773) 751-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X Primary

Addresses

Primary practice location

3319 N Elston Ave
Suite 100
Chicago, IL 60618-5811

Mailing address

3319 N Elston Ave
Suite 200
Chicago, IL 60618-5811
Phone (773) 751-7200

Other names 1

  • Mobile Doctors of Chicago Podiatry Doing business as

National Provider Directory

National Provider Directory

Locations

3319 N Elston Ave
#100
Chicago, IL 60618
Phone (773) 751-7200

3319 N Elston Ave
Ste 100
Chicago, IL 60618
Phone (773) 751-7200

3319 N Elston Ave
Ste 200
Chicago, IL 60618
Phone (312) 312-7525

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1992870281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MI MOBILE DOCTORS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "TYSYN",
        "authorized_official_title_or_position": "DIRECTOR, QUALITY ASSURANCE",
        "authorized_official_telephone_number": "773-751-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Doctors of Chicago Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.