Provider Demographics
NPI:1902131840
Name:BAALTZ MOBILE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:BAALTZ MOBILE HEALTH SERVICES INC
Other - Org Name:WALKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:W
Authorized Official - Last Name:ZAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:312-243-3769
Mailing Address - Street 1:1226 W TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4709
Mailing Address - Country:US
Mailing Address - Phone:312-243-3769
Mailing Address - Fax:312-243-3840
Practice Address - Street 1:1226 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4709
Practice Address - Country:US
Practice Address - Phone:312-243-3769
Practice Address - Fax:312-243-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016002513213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
600204762OtherBLUE CROSS BLUE SHIELD
IL016002513Medicaid
T36849Medicare UPIN
IL519450Medicare PIN