Provider Demographics
NPI:1245976075
Name:LUNDIE, LANCE CHRISTOPHER (DPM)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:CHRISTOPHER
Last Name:LUNDIE
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 1:1001 S STATE ST UNIT 3607
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2244
Mailing Address - Country:US
Mailing Address - Phone:810-748-7171
Mailing Address - Fax:
Practice Address - Street 1:3260 W 111TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2729
Practice Address - Country:US
Practice Address - Phone:773-239-0702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL016.006126213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program