MAUREEN MCSHANE DPM LLC (NPI# 1972742872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972742872 |
| Entity Type | Organization |
| Organization Name | MAUREEN MCSHANE DPM LLC |
| Practice Address |
11238 S Western Ave Chicago IL 60643-4116 |
| Practice Telephone | 7732330990 |
| Practice Fax Number | 7732330992 |
| Mailing Telephone | 7732330990 |
| Mailing Fax Number | 7732330992 |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2015-08-17 |
| Authorized Official Name | DR. MAUREEN T MCSHANE (OWNER) |
| Authorized Official Telephone | 7732330990 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016004635 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BC/BS OF ILLINOIS | 001605234 | 01 |
| Street Address |
11238 S WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-4116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962022095 | Raveena Shah | Dentist | 11238 S Western Ave, Chicago, IL 60643-4116 | 2020-04-18 |
| 1881172781 | Jacqueline M Khilfeh | Nurse Practitioner | 11238 S Western Ave, Chicago, IL 60643-4116 | 2018-08-02 |
| 1821316647 | Life Source Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 11238 S Western Ave, Chicago, IL 60643-4116 | 2010-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533700 | Podiatric Management Systems LLC | Podiatrist | 537 W 31st St, Chicago, IL 60616-3294 | 2020-09-18 |
| 1679187090 | Podiatric Management Systems LLC | Podiatrist | 5600 W Addison St Lowr 2ll, Chicago, IL 60634-4499 | 2020-09-02 |
| 1932742848 | Foot and Ankle Care & Associates, Ltd | Podiatrist | 3320 W 63rd St, Chicago, IL 60629-3317 | 2019-10-23 |
| 1437622966 | Tomasz Szmyd Dpm, PC | Podiatrist | 1500 E 67th St, Chicago, IL 60637-4427 | 2019-01-08 |
| 1548746761 | Jeremy Marchand | Podiatrist | 2751 W Winona St Rm Ap457, Chicago, IL 60625-2508 | 2018-07-11 |
| 1770004814 | Andrew Alward | Podiatrist | 2027 W Division St # 180, Chicago, IL 60622-9024 | 2017-06-28 |
| 1043730625 | Mary Elizabeth Hickner | Podiatrist | 2751 W Winona St Apt 457, Chicago, IL 60625-2508 | 2017-06-23 |
| 1225489172 | Alison Dawn Traffanstedt Young | Podiatrist | 30 N Michigan Ave Ste 1129, Chicago, IL 60602-3478 | 2016-06-22 |
| 1922454131 | Mary Cobb | Podiatrist | 1428 E 69th St, Chicago, IL 60637-4804 | 2016-05-05 |
| 1407233760 | Aaron Raestas | Podiatrist | 730 S Dearborn St # T, Chicago, IL 60605-1838 | 2015-05-06 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.