Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beverly Podiatry Center, LLC

Organization Podiatrist · NPI 1790777118

Beverly Podiatry Center, LLC is a Podiatrist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9933 S Western Ave Ste 102
Chicago, IL 60643-1810
Phone: (773) 445-8700
Fax: (773) 445-4646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X (IL)
Podiatrist Taxonomy 213E00000X (IL)
Public Medicine Podiatrist Taxonomy 213EP0504X (IL)
Primary Podiatric Medicine Podiatrist Taxonomy 213EP1101X (IL)
Foot Surgery Podiatrist Taxonomy 213ES0131X (IL)

Record details

NPI number1790777118
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fortunee Massuda — Medical Director/Ceo · (773) 445-8700
NPI enumeratedAugust 22, 2005
Last updated in NPPESNovember 12, 2009
Mailing address9933 S Western Ave, Suite 102, Chicago, IL 60643-1810

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