Dr Thomas Daniel Paholak, DPM | |
12786 Lasalle Ln, Huntington Woods, MI 48070-1020 | |
(248) 572-3900 | |
(248) 572-1277 |
Full Name | Dr Thomas Daniel Paholak |
---|---|
Gender | Male |
Speciality | Podiatry |
Experience | 35 Years |
Location | 12786 Lasalle Ln, Huntington Woods, Michigan |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710934955 | NPI | - | NPPES |
016-004340 | Other | IL | IL STATE LICENSE |
0001623503 | Other | IL | BCBS |
016-004340 | Medicaid | IL | |
480027688 | Other | IL | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 016004340 (Illinois) | Secondary |
213ES0131X | Podiatrist - Foot Surgery | 016-004340 (Illinois) | Secondary |
213E00000X | Podiatrist | 5901001714 (Michigan) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Premier Podiatry Services Ltd | 8820007180 | 3 |
Premier Podiatry Services Ltd | 8820007180 | 3 |
Provider Name | Premier Podiatry Services Ltd |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1528250669 PECOS PAC ID: 8820007180 Enrollment ID: O20060413000474 |
Mailing Address | Practice Location Address |
---|---|
Dr Thomas Daniel Paholak, DPM 6374 N Lincoln Ave Ste 303, Chicago, IL 60659-1283 Ph: (773) 866-9800 | Dr Thomas Daniel Paholak, DPM 12786 Lasalle Ln, Huntington Woods, MI 48070-1020 Ph: (248) 572-3900 |
Mobile Podiatry Services, Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 12786 Lasalle Ln, Huntington Woods, MI 48070 Phone: 773-263-8540 Fax: 773-866-1733 | |
Robert D Adas Dpm & Larry H Wexler Dpm Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 26831 Woodward Ave, Huntington Woods, MI 48070 Phone: 248-399-5905 Fax: 248-399-5906 |