Podomedik Clinics Llc.

NPI Registration Record

Provider / Organization	NPI	Date Certified
PODOMEDIK CLINICS LLC.	1932454279	2023-11-10

The organization Podomedik Clinics Llc. is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1932454279. Registration indicates Podomedik Clinics Llc. is a provider of services with a specialization in Ambulatory Health Care Facilities, Clinic/Center (Clinic/Center: Podiatric, ) (Clinic/Center Podiatric, Ambulatory Health Care Facilities) (Clinic/Center, ) (Ambulatory Health Care Facilities, Clinic/Center) (Clinic/Center: Podiatric, ) (Clinic/Center Podiatric, Ambulatory Health Care Facilities) (Clinic/Center, )

Other Names:

Gerardo Perez Single Member

Entity Type	Organization

Provider Organization	PODOMEDIK CLINICS LLC.
Other Provider Organization	GERARDO PEREZ SINGLE MEMBER
Practice Office Address	159 N GREENLEAF ST STE 1 GURNEE, IL US
Practice Office Telephone	8472493888
Practice Office Fax	8475747477
Mailing Address	159 N GREENLEAF ST STE 1 GURNEE, IL 600313341 US
Business Telephone	8472493888
Business Fax	8475747477
Authorized Official	GERARDO PEREZ ESPINDOLA, OWNER/PROVIDER 4147194799

HPT Codes

Code	Practice	License No State
261QP1100X PRIMARY	Ambulatory Health Care Facilities Clinic/Center Clinic/Center: Podiatric Clinic/Center Podiatric Ambulatory Health Care Facilities Clinic/Center	016005265 IL
261QP1100X	Ambulatory Health Care Facilities Clinic/Center Clinic/Center: Podiatric Clinic/Center Podiatric Ambulatory Health Care Facilities Clinic/Center	91125 WI

OPI Codes

016005265	MEDICAID	IL
43241500	MEDICAID	WI
WI1874	OTHER	WI	MEDICARE PTAN
IL4062	OTHER	IL	MEDICARE PTAN
1932454279	OTHER	WI	GROUP NPI

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