NPIMap

Organization Active NPI

Camilleri Medical Center LTD

  • Foot & Ankle Surgery Podiatrist
  • Berwyn, IL
National Provider Identifier
1225248396
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016004695 Issued in IL
Legal business name
CAMILLERI MEDICAL CENTER LTD
Practice address
6845 Stanley Ave
Berwyn, IL 60402-3041
Phone
(708) 788-5239
Fax
(708) 788-3618
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Authorized official

Name
Dr. Mark Camilleri, DPMNPI 1912992470
Title
Owner/Ceo
Phone
(708) 788-5239

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016004695 IL Primary

Addresses

Primary practice location

6845 Stanley Ave
Berwyn, IL 60402-3041

Mailing address

6845 Stanley Ave
Berwyn, IL 60402-3041
Phone (708) 788-5239

Other practice location 1

3350 Ridge Rd
Lansing, IL 60438-3112
Phone (708) 474-1040

Other identifiers 1

IdentifierTypeStateIssuer
60001136OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Camilleri Medical Center LTD Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040218000028 IL Part B Supplier - Clinic/Group Practice 3779478847 Receives reassigned benefits from 4 practitioners
Practice locations: Berwyn, IL
O20101029000294 IL DME Supplier - Physician - PodiatryDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 3779478847 Practice locations: Berwyn, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ridgeland Foot and Ankle Center LTD6845 Stanley Ave, Berwyn, IL 60402-3041(708) 788-5232 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Jan 1, 2011

National Provider Directory

National Provider Directory

Locations

6845 Stanley Ave
Berwyn, IL 60402
Phone (708) 788-5232

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1225248396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023041",
            "telephone_number": "708-788-5239",
            "fax_number": "708-788-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023041",
            "telephone_number": "708-788-5239",
            "fax_number": "708-788-3618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "IL",
            "postal_code": "604383112",
            "country_code": "US",
            "telephone_number": "708-474-1040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAMILLERI MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "CAMILLERI",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "708-788-5239",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60001136",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camilleri Medical Center LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.