Active NPI
Robert M Joseph, DPM
- Foot & Ankle Surgery Podiatrist
- North Chicago, IL
National Provider Identifier
1124052717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 016.005534
- Practice address
- 3471 Green Bay Rd
North Chicago, IL 60064-3090 - Phone
- (937) 479-1793
- Fax
- (847) 775-6587
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 003440 | OH | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016.005534 | IL | Primary |
Addresses
Primary practice location
3471 Green Bay Rd
North Chicago, IL 60064-3090
Mailing address
3471 Green Bay Rd
North Chicago, IL 60064-3090
Phone (937) 479-1793
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2684751 | Other | OH | MEDICAID |
| 421534506145 | Other | OH | CARESOURCE |
| 421534506011 | Other | OH | TRICARE |
| 7195856 | Other | OH | AETNA |
| 000000605109 | Other | OH | BCBS-OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003440 | OH | MD | Podiatrist |
| 016.005534 | IL | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1124052717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3471 GREEN BAY RD",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600643090",
"telephone_number": "937-479-1793",
"fax_number": "847-775-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3471 GREEN BAY RD",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600643090",
"telephone_number": "937-479-1793",
"fax_number": "847-775-6587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "ROBERT",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OH",
"license": "003440",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "016.005534",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "2684751",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "421534506145",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "421534506011",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7195856",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-OH",
"identifier": "000000605109",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.