Chicago Podiatry PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

CHICAGO PODIATRY PLLC

Practice address

4700 W 95TH St Ste 203
Oak Lawn, IL 60453-2574

Phone

(708) 274-7876

NPI assigned

Sep 20, 2023

Organization subpart

No

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

Authorized official

Name

Jannah BacchusNPI 1437505492

Title

Co-Owner

Phone

(260) 580-3677

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Jannah Faiza Bacchus, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Alexandria, VA
  • NPI 1437505492

  IL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1235917238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 KAREN DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674481",
            "telephone_number": "260-580-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W 95TH ST STE 203",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532574",
            "telephone_number": "708-274-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "JANNAH",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "260-580-3677"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana N Chen
• Yaping Chen
• Lina Chervak, MD
• Darshika Chhabra, MD
• Chicago Hearing LLC
• Chicago South Orthopedics, Inc
• Chicagoland Pediatric Partners PC
• Krystina Chickerillo, MSN,FNP-BC
• Aida Altagracia Chicon
• Childhood Trauma Treatment Program of Advocate Health & Hospitals Corp

• Foot & Ankle Surgery Podiatrist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.