| Preferred Podiatry Group Of Michigan Pc | |
|
225 W Washington St Ste 1500, Chicago, IL 60606-3485 | |
| (847) 502-4898 | |
| Not Available |
| Full Name | Preferred Podiatry Group Of Michigan Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 225 W Washington St Ste 1500, Chicago, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366086886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Lynn Petronella |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1770712358 PECOS PAC ID: 6901062587 Enrollment ID: I20120726000068 |
| Provider Name | Stevin Christopher Kestner |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457399354 PECOS PAC ID: 8224223219 Enrollment ID: I20191230000519 |
| Provider Name | Ashim Wadehra |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821448721 PECOS PAC ID: 0143554840 Enrollment ID: I20200512002100 |
| Provider Name | Roger Zeratsky |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144336066 PECOS PAC ID: 5395829667 Enrollment ID: I20210217002123 |
| Provider Name | Winston Wong |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1245362037 PECOS PAC ID: 5597990911 Enrollment ID: I20230403001248 |
| Provider Name | Marc Waldman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366419236 PECOS PAC ID: 3173617990 Enrollment ID: I20231204002172 |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Podiatry Group Of Michigan Pc Po Box 772294, Detroit, MI 48277-2294 Ph: (847) 504-5000 | Preferred Podiatry Group Of Michigan Pc 225 W Washington St Ste 1500, Chicago, IL 60606-3485 Ph: (847) 502-4898 |
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