Dupage Foot & Ankle Associates

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016003067 Issued in IL

Legal business name

DUPAGE FOOT & ANKLE ASSOCIATES

Practice address

14 S Addison St
Bensenville, IL 60106-2126

Phone

(630) 766-8720

Fax

(630) 766-9228

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Rudolph J Petrich, DPMNPI 1851313019

Title

Owner

Phone

(630) 766-8720

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Rudolph J. Petrich, DPM

  • Podiatrist
  • Bensenville, IL
  • NPI 1851313019
  NPD Authorized official

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1124206834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S ADDISON ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062126",
            "telephone_number": "630-766-8720",
            "fax_number": "630-766-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S ADDISON ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062126",
            "telephone_number": "630-766-8720",
            "fax_number": "630-766-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE FOOT & ANKLE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "PETRICH",
        "authorized_official_first_name": "RUDOLPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-766-8720",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Bensenville, IL
• Providers in Bensenville, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.