Active NPI
Vincent Anthony Perns, DPM
- Foot & Ankle Surgery Podiatrist
- Chicago, IL
National Provider Identifier
1043213713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 016002468
- Practice address
- 3115 N Harlem Ave
Ste 200
Chicago, IL 60634-4684 - Phone
- (773) 836-9900
- Fax
- (773) 836-9935
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016002468 | IL | Primary |
Addresses
Primary practice location
3115 N Harlem Ave
Ste 200
Chicago, IL 60634-4684
Mailing address
3115 N Harlem Ave
Ste 200
Chicago, IL 60634-4684
Phone (773) 836-9900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016002468 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016002468 | IL | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380585600000",
"number": "1043213713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3115 N HARLEM AVE",
"address_2": "STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606344684",
"telephone_number": "773-836-9900",
"fax_number": "773-836-9935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 N HARLEM AVE",
"address_2": "STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606344684",
"telephone_number": "773-836-9900",
"fax_number": "773-836-9935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERNS",
"first_name": "VINCENT",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2013-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "016002468",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016002468",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.