Dr Tegan a Timesh Footcare Clinic P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

DR TEGAN A TIMESH FOOTCARE CLINIC P.C.

Practice address

4040 W Peterson Ave
Chicago, IL 60646-6019

Phone

(773) 267-0554

Fax

(773) 267-6258

NPI assigned

Sep 26, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tegan Augustine Thimesch I, DPMNPI 1376511287

Title

President

Phone

(773) 267-0554

Specialties & licenses 1

Addresses

Other names 1

• FOOTCARE CLINIC P.C. Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Fox Lake Foot Care LTD

  • Foot & Ankle Surgery Podiatrist
  • Ingleside, IL
  • NPI 1699053967

  O20090603000682

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tegan Augustine Thimesch I, DPM

  • Foot Surgery Podiatrist
  • Chicago, IL
  • NPI 1376511287
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1023268901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466019",
            "telephone_number": "773-267-0554",
            "fax_number": "773-267-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466019",
            "telephone_number": "773-267-0554",
            "fax_number": "773-267-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TEGAN A TIMESH FOOTCARE CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "THIMESCH",
        "authorized_official_first_name": "TEGAN",
        "authorized_official_middle_name": "AUGUSTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-267-0554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOTCARE CLINIC P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.