Organization Active NPI

DRS Valdes and Kulekowskis Podiatry PC

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1093951303
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016005127 Issued in IL
Legal business name
DRS VALDES AND KULEKOWSKIS PODIATRY PC
Practice address
1044 N Francisco Ave Ste 203
Chicago, IL 60622-2743
Phone
(773) 248-4111
Fax
(312) 824-6703
NPI assigned
Dec 17, 2008
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Annmarie KulekowskisNPI 1841295342
Title
Owner
Phone
(773) 248-4111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016005127 IL Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1044 N Francisco Ave Ste 203
Chicago, IL 60622-2743

Mailing address

1044 N Francisco Ave Ste 203
Chicago, IL 60622-2743
Phone (773) 248-4111

Other identifiers 2

IdentifierTypeStateIssuer
016003592MedicaidIL
016005127MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090518000224 IL Part B Supplier - Clinic/Group Practice 2769531029 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL
O20100930079946 IL DME Supplier - Physician - Podiatry 2769531029 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

1044 N Francisco Ave
Ste 203
Chicago, IL 60622
Phone (312) 527-6500

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1093951303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222743",
            "telephone_number": "773-248-4111",
            "fax_number": "312-824-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE STE 203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222743",
            "telephone_number": "773-248-4111",
            "fax_number": "312-824-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS VALDES AND KULEKOWSKIS PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "KULEKOWSKIS",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-248-4111"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005127",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003592",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005127",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.