Provider Demographics
NPI:1194884452
Name:NEAMAND, MARK E (DPM)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:NEAMAND
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 1:621 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4732
Mailing Address - Country:US
Mailing Address - Phone:847-698-2895
Mailing Address - Fax:847-698-2942
Practice Address - Street 1:621 DEVON AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4732
Practice Address - Country:US
Practice Address - Phone:847-698-2895
Practice Address - Fax:847-698-2942
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004983213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1626856OtherBC/BS OF IL
ILP00163244OtherRAILROAD MEDICARE
IL1626856OtherBC/BS OF IL
ILU82665Medicare UPIN
IL203029Medicare ID - Type Unspecified