Individual provider Active NPI

Michael Martin Fishkin, C.PED

  • Pedorthist
  • Crystal Lake, IL
National Provider Identifier
1073015269
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PedorthistTaxonomy code 224L00000X
License
212.010327 Issued in IL
Practice address
750 E Terra Cotta Ave Ste C
Crystal Lake, IL 60014-3621
Phone
(847) 639-5800
NPI assigned
Mar 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pedorthist 224L00000X 212.010327 IL Primary

Addresses

Primary practice location

750 E Terra Cotta Ave Ste C
Crystal Lake, IL 60014-3621

Mailing address

508 Abbeywood Dr
Cary, IL 60013-2470
Phone (847) 915-0547

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Best Foot First, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1073015269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 ABBEYWOOD DR",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132470",
            "telephone_number": "847-915-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "847-639-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHKIN",
        "first_name": "MICHAEL",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "C.PED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-02",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "IL",
            "license": "212.010327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.