NPIMap

Organization Active NPI

Absolute Foot and Ankle Clinic LTD

  • Podiatrist
  • Northbrook, IL
National Provider Identifier
1124089479
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016005115 Issued in IL
Legal business name
ABSOLUTE FOOT AND ANKLE CLINIC LTD
Practice address
3546 N Milwaukee Ave
Northbrook, IL 60062
Phone
(847) 297-9660
Fax
(847) 297-9665
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Zinoviy Rabinovich, DPMNPI 1356561534
Title
President
Phone
(847) 297-9660

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 016005115 IL Primary

Addresses

Primary practice location

3546 N Milwaukee Ave
Northbrook, IL 60062

Mailing address

3546 N Milwaukee Ave
Northbrook, IL 60062
Phone (847) 297-9660

Other identifiers 1

IdentifierTypeStateIssuer
016005115MedicaidIL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040825001181 IL Part B Supplier - Clinic/Group Practice 2769456664 Receives reassigned benefits from 1 practitioner
Practice locations: Northbrook, IL
O20100930073959 IL DME Supplier - Physician - Podiatry 2769456664 Practice locations: Northbrook, IL

National Provider Directory

National Provider Directory
Tax ID family
Absolute Foot Ankle Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

237 W Dundee Rd
Buffalo Grove, IL 60089
Phone (847) 537-4320

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1124089479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 N MILWAUKEE AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-297-9660",
            "fax_number": "847-297-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3546 N MILWAUKEE AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-297-9660",
            "fax_number": "847-297-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSOLUTE FOOT AND ANKLE CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "RABINOVICH",
        "authorized_official_first_name": "ZINOVIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-297-9660",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005115",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.