Provider Demographics
NPI:1124138805
Name:RACHOY, JOHN P (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:RACHOY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9445 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2811
Mailing Address - Country:US
Mailing Address - Phone:219-836-1060
Mailing Address - Fax:219-836-1014
Practice Address - Street 1:9445 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2811
Practice Address - Country:US
Practice Address - Phone:219-836-1060
Practice Address - Fax:219-836-1014
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000920A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200308230Medicaid
IN200308230AMedicaid
IL016004953-2Medicaid
IN200308230Medicaid
KS499500A7Medicare PIN
IL016004953-2Medicaid
IN5199290001Medicare NSC
IN200308230AMedicaid