Evanston Podiatry Center

NPI #1043202559 in Evanston, Illinois

Provider Information

NPI Number: 1043202559
Entity Type: Organization
Organization Name: Evanston Podiatry Center
Primary Specialty: Podiatrist - Foot & Ankle Surgery
Enumeration Date: Aug 19, 2005
Last Updated: Jul 3, 2008

Practice Location

Address: 1605 CHICAGO AVE
City: Evanston
State: Illinois
ZIP Code: 60201-4504
Phone: (847) 424-9888

Authorized Official

Name: MRS. FORTUNEE MASSUDA, DPM
Title: MEDICAL DIRECTOR & CEO
Phone: (847) 424-9888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X
Podiatrist - Foot Surgery — Foot Surgery	213ES0131X
Podiatrist - Primary Podiatric Medicine — Primary Podiatric Medicine	213EP1101X
Podiatrist - Public Medicine — Public Medicine	213EP0504X
Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery	213ES0103X	Primary

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