Organization Active NPI

Footsteps of Illinois, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Rockford, IL
National Provider Identifier
1184339376
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOTSTEPS OF ILLINOIS, PLLC
Practice address
6999 Redansa Dr Ste 5a
Rockford, IL 61108-1201
Phone
(815) 229-1008
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Zubair Khan, DPMNPI 1780050195
Title
Owner/Authorized Official
Phone
(815) 229-1008

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

6999 Redansa Dr Ste 5a
Rockford, IL 61108-1201

Mailing address

6999 Redansa Dr Ste 5a
Rockford, IL 61108-1201
Phone (815) 229-1008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230313000519 IL Part B Supplier - Clinic/Group Practice 9739553843 Receives reassigned benefits from 1 practitioner
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

6999 Redansa Dr
Ste 5A
Rockford, IL 61108
Phone (815) 229-1008

Practitioners & affiliated clinicians

Practitioners 1

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": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1184339376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6999 REDANSA DR STE 5A",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081201",
            "telephone_number": "815-229-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6999 REDANSA DR STE 5A",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081201",
            "telephone_number": "815-229-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTSTEPS OF ILLINOIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ZUBAIR",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "815-229-1008",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.