Individual provider Active NPI

William R. Storino, DPM

  • Primary Podiatric Medicine Podiatrist
  • Grayslake, IL
National Provider Identifier
1063417921
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
016-004694 Issued in IL
Practice address
1170 E Belvidere Rd
Ste 202
Grayslake, IL 60030-2076
Phone
(847) 566-8580
Fax
(847) 566-2818
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 016-004694 IL Primary

Addresses

Primary practice location

1170 E Belvidere Rd
Ste 202
Grayslake, IL 60030-2076

Mailing address

1170 E Belvidere Rd
Ste 202
Grayslake, IL 60030-2076
Phone (847) 566-8580

Other identifiers 6

IdentifierTypeStateIssuer
016-05176OtherILBLUE CROSS BLUE SHIELD
480030836OtherILMEDICARE RAILROAD
016004694MedicaidIL
9053889OtherILPCHS
5409760001OtherILDMEPOS
3418679001OtherILCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000572 IL Practitioner - Podiatry 2365476389 Practice locations: Grayslake, IL; Gurnee, IL; Libertyville, IL

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1170 E Belvidere Rd
Suite 202
Grayslake, IL 60030-2076
Phone (847) 566-8580

500 N Hunt Club Rd
Gurnee, IL 60031-2416
Phone (847) 856-8100

610 Peterson Rd
Libertyville, IL 60048-1014
Phone (847) 367-6100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue263
Removal or shaving of skin growth75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-004694ILMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1063417921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "STE 202",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302076",
            "telephone_number": "847-566-8580",
            "fax_number": "847-566-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 E BELVIDERE RD",
            "address_2": "STE 202",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302076",
            "telephone_number": "847-566-8580",
            "fax_number": "847-566-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORINO",
        "first_name": "WILLIAM",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016-004694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "016-05176",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480030836",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004694",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCHS",
            "identifier": "9053889",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS",
            "identifier": "5409760001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3418679001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.