NPIMap

Organization Active NPI

The Foot and Ankle Wellness Center, LLC

  • Podiatrist
  • Matteson, IL
National Provider Identifier
1194094607
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
316.001386 Issued in IL
Legal business name
THE FOOT AND ANKLE WELLNESS CENTER, LLC
Practice address
4440 Lincoln Hwy
Suite 102
Matteson, IL 60443-2349
Phone
(708) 481-3338
Fax
(708) 481-8643
NPI assigned
Dec 29, 2011
Last updated
Dec 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Dr. Terri' L Foster, D.P.M.NPI 1720010481
Title
Podiatrist
Phone
(708) 481-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 316.001386 IL Primary

Addresses

Primary practice location

4440 Lincoln Hwy
Suite 102
Matteson, IL 60443-2349

Mailing address

4440 Lincoln Hwy
Suite 102
Matteson, IL 60443-2349
Phone (708) 481-3338

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1194094607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 LINCOLN HWY",
            "address_2": "SUITE 102",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432349",
            "telephone_number": "708-481-3338",
            "fax_number": "708-481-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 LINCOLN HWY",
            "address_2": "SUITE 102",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432349",
            "telephone_number": "708-481-3338",
            "fax_number": "708-481-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOOT AND ANKLE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "TERRI'",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "708-481-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "316.001386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.