Dale Steven Brink, DPM, FACFAS

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016-004747 Issued in IL

Practice address

401 E 162ND St Ste 101
South Holland, IL 60473-2237

Phone

(708) 596-3757

Fax

(708) 596-3779

NPI assigned

Aug 1, 2006

Last updated

Dec 2, 2009By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

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 2

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ingalls Home Care Inc. Home health agency, Harvey, IL, CCN 147435
• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
• Community Hospital Hospital, Munster, IN, CCN 150125
• Ingalls Memorial Hospital Inpatient rehabilitation facility, Harvey, IL, CCN 14T191

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dale.brink.1@20978.direct.athenahealth.com
• Direct secure messaging: dbrink226714@uchospital.direct-ci.com

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.

• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786

  IN

  Medicare reassignment Care Compare group NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• Performance Foot and Ankle Center LLC

  • Podiatrist
  • Orland Park, IL
  • NPI 1104004290
  Authorized official Same address or phone
• Performance Foot and Ankle Center LLC

  • Podiatrist
  • South Holland, IL
  • NPI 1750397428
  Authorized official Same address or phone
• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ingalls Memorial Hospital

  • Rehabilitation Hospital Unit
  • Harvey, IL
  • NPI 1023105566

  Inpatient rehabilitation facility

  Care Compare affiliation
• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation
• Ucm Home Care

  • Home Health Agency
  • Harvey, IL
  • NPI 1417998865
  Care Compare affiliation
• Munster Medical Research Foundation Inc

  dba Community Hospital

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1093722365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 162ND ST STE 101",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732237",
            "telephone_number": "708-596-3757",
            "fax_number": "708-596-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 162ND ST STE 101",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732237",
            "telephone_number": "708-596-3757",
            "fax_number": "708-596-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINK",
        "first_name": "DALE",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DPM, FACFAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016-004747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004747",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erinn Boone
• Chenelle Boss
• Branc Mobility Inc
• Jeffrey W Branta, D.O.
• Gail Briggs, REGISTERED NURSE
• Jahmiaa C Brooks
• Mark James Broomhead, DDS
• Josalynn M Brown, FNP-C
• Latoya Brown
• Bonnie Brownlee

• Podiatrist in South Holland, IL
• Providers in South Holland, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.