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

Lake Shore Podiatry Center, LLC

Organization Podiatrist · NPI 1366548018

Lake Shore Podiatry Center, LLC is a Podiatrist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
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

4733 N Damen Ave
Chicago, IL 60625-1442
Phone: (773) 871-2250
Fax: (773) 697-0134
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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 number1366548018
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fortunee Massuda — Medical Director & Ceo · (773) 233-3800
NPI enumeratedSeptember 16, 2006
Last updated in NPPESJuly 17, 2008
Mailing address9933 S Western Ave, Suite 102, Chicago, IL 60643-1810

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