Performance Foot and Ankle Center LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016004747 Issued in IL

Legal business name

PERFORMANCE FOOT AND ANKLE CENTER LLC

Practice address

15300 West Ave
Suite 210
Orland Park, IL 60462-4600

Phone

(708) 873-9440

Fax

(708) 873-1862

NPI assigned

Jan 31, 2008

Organization subpart

Yes

Parent organization

PERFORMANCE FOOT AND ANKLE CENTER LLCAs reported in NPPES

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

Authorized official

Name

Dr. Dale S Brink, DPM

Title

Owner

Phone

(708) 596-3757

Specialties & licenses 2

Addresses

Part of

Performance Foot and Ankle Center LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Performance Foot and Ankle Center LLC

  • Podiatrist
  • South Holland, IL
  • NPI 1750397428
  NPPES parent name

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1104004290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 162ND ST",
            "address_2": "SUITE 101",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732236",
            "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": "15300 WEST AVE",
            "address_2": "SUITE 210",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-873-9440",
            "fax_number": "708-873-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERFORMANCE FOOT AND ANKLE CENTER LLC",
        "enumeration_date": "2008-01-31",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-596-3757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004747",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "5000520001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Pellack
• Jade Alexa Pellerito, OTR/L
• Janet Pepich, PT
• Dmitriy Peresada, MD
• Perfect Fit Footwear
• Performance Physical Therapy of Palos Park
• Michelle Perisic, DC
• Shirley Perolino, PT
• Maria Perozzi, PA
• Frances Perry, MOT, OTR/L

• Podiatrist in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.