Jack Robert Chulengarian, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016002637 Issued in IL

Practice address

1200 N Green Bay Rd
Waukegan, IL 60085-2246

Phone

(847) 249-3338

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

• Advanced Podiatric Surgical Services LLC

  • Ambulatory Surgical Clinic/Center
  • Waukegan, IL
  • NPI 1871722918
  Authorized official Same address or phone
• Jack Chulengarian DPM PC

  dba Lake County Foot & Ankle LTD

  • Foot & Ankle Surgery Podiatrist
  • Waukegan, IL
  • NPI 1659454577
  Authorized official Same address or phone

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1083615371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852246",
            "telephone_number": "847-249-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852246",
            "telephone_number": "847-249-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHULENGARIAN",
        "first_name": "JACK",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016002637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04932042",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480025062",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carleton Childs, B.A.
• Chiro One Wellness Center of Waukegan LLC
• Henry Kwang-Suk Cho, D.M.D
• Harry Chong, L AC.
• Evelyn H Chou, NP
• Jisun Rebecca Chung
• Kelli A Ciolek
• Circle of Care
• Elisa Cisneros
• City of Waukegan Illinois (Waukegan Fire Department)

• Foot & Ankle Surgery Podiatrist in Waukegan, IL
• Providers in Waukegan, 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 Apr 25, 2012; 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.