Essington Medical Group, Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016005698 Issued in IL

Legal business name

ESSINGTON MEDICAL GROUP, INC

Doing business as

Southshore Foot and ankle surgery

Practice address

1026 Essington Rd
Joliet, IL 60435-2841

Phone

(714) 244-0101

NPI assigned

Apr 11, 2016

Last updated

Jul 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. An Duy Le, DPMNPI 1215377841

Title

Owner

Phone

(714) 244-0101

Specialties & licenses 1

Addresses

Other names 1

• Southshore Foot and ankle surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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.

• An D Le, DPM

  • Foot & Ankle Surgery Podiatrist
  • Joliet, IL
  • NPI 1215377841
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1053775593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 ESSINGTON RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352841",
            "telephone_number": "714-244-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 ESSINGTON RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604352841",
            "telephone_number": "714-244-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSINGTON MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "AN",
        "authorized_official_middle_name": "DUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-244-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southshore Foot and ankle surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie Erickson
• Ernesto Tan, M.D.S.C.
• Shaun Matthew Ernst, DPT
• Kanchana Esariya-Umpai, M.D.
• Esk Home Services (Home Helpers 58389)
• Essington Pharmacy
• Estelle Fletcher MD PHD Family Doctor S.C.
• Etcetera Treatment and Counseling
• Kristine Eubanks, M.A. CCC-A
• Devan Evans, MD

• Foot & Ankle Surgery Podiatrist in Joliet, IL
• Providers in Joliet, 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 Jul 27, 2016; 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.