Footco Orthopedic

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

212.000115 Issued in IL

Legal business name

FOOTCO ORTHOPEDIC

Practice address

3723 N Southport Ave
Chicago, IL 60613-3718

Phone

(312) 409-2175

NPI assigned

May 28, 2008

Organization subpart

No

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

Authorized official

Name

Tim Porcelli, LC PED

Title

Director, Chief Clinician

Phone

(312) 409-2175

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Timothy W Porcelli, LCPED

  • Orthotist
  • Chicago, IL
  • NPI 1699896431
  NPD (past)

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1124286927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13377",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606130377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133718",
            "telephone_number": "312-409-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTCO ORTHOPEDIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "PORCELLI",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR, CHIEF CLINICIAN",
        "authorized_official_telephone_number": "312-409-2175",
        "authorized_official_credential": "LC PED"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "212.000115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1670909",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Foot and Ankle Health Care Center
• Foot and Ankle Treatment Center of Chicago, LLC
• Foot Care Consultants
• Foot First Podiatry Centers VPC
• Footcare at Home PC
• Miranda G Foote
• Anna E Footerman
• Foothealth USA LLC
• Footholds Therapy Group PLLC
• Footwise Podiatry, LTD.

• Customized Equipment (DME) in Chicago, IL
• Providers in Chicago, IL by specialty
• Customized Equipment (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.