Provider Demographics
NPI:1962408864
Name:ALAMEDA, DAVID JR (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:ALAMEDA
Suffix:JR
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 1:4959 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-4332
Mailing Address - Country:US
Mailing Address - Phone:773-237-1122
Mailing Address - Fax:773-237-1222
Practice Address - Street 1:4959 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-4332
Practice Address - Country:US
Practice Address - Phone:773-237-1122
Practice Address - Fax:773-237-1222
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-003617213ES0131X, 213EP1101X
IL016003617213ES0103X, 213E00000X, 213EP0504X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL00000026502 28OtherUNITED HEALTHCARE
IL3106623-003OtherCIGNA
IL5852442OtherAETNA
IL3106623-005OtherCIGNA
IL00000026502 28OtherUNITED HEALTHCARE
ILL77543Medicare PIN
ILL78199Medicare PIN
ILT38811Medicare UPIN
IL3106623-003OtherCIGNA