Provider Demographics
NPI:1891800256
Name:LARRY E. ERLINDER DPM, LTD
Entity type:Organization
Organization Name:LARRY E. ERLINDER DPM, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:ELDRIDGE
Authorized Official - Last Name:ERLINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:708-388-3910
Mailing Address - Street 1:4417 147TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-2643
Mailing Address - Country:US
Mailing Address - Phone:708-388-3910
Mailing Address - Fax:708-388-3911
Practice Address - Street 1:4417 147TH ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-2643
Practice Address - Country:US
Practice Address - Phone:708-388-3910
Practice Address - Fax:708-388-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
60001061OtherBC/BS ID
60001061OtherBC/BS ID
T36970Medicare UPIN