Provider Demographics
NPI:1881486561
Name:PODIATRIC WOUND CARE CHICAGO LLC
Entity type:Organization
Organization Name:PODIATRIC WOUND CARE CHICAGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ST. PETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-726-9899
Mailing Address - Street 1:5801 N SHERIDAN RD APT 2E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3804
Mailing Address - Country:US
Mailing Address - Phone:773-726-9899
Mailing Address - Fax:773-825-8203
Practice Address - Street 1:5801 N SHERIDAN RD APT 2E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3804
Practice Address - Country:US
Practice Address - Phone:773-726-9899
Practice Address - Fax:773-825-8203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty