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 1679670905

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

2143 W Wellington Ave
Chicago, IL 60618-8268
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

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

Record details

NPI number1679670905
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Fortunee Massuda — Medical Director & Ceo · (773) 233-0590
NPI enumeratedSeptember 20, 2006
Last updated in NPPESFebruary 14, 2008
Mailing address9933 S Western Ave, Suite 102, Chicago, IL 60643-1810

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