Brookfield Podiatry Center

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016003689 Issued in IL

Legal business name

BROOKFIELD PODIATRY CENTER

Practice address

14 S. Addison Street
Bensenville, IL 60106

Phone

(630) 390-8360

NPI assigned

Jan 2, 2008

Last updated

May 7, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

THOMAS J. MACKAs reported in NPPES

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

Authorized official

Name

Dr. Thomas J. MackNPI 1548265689

Title

Owner

Phone

(630) 390-8360

Specialties & licenses 2

Addresses

Part of

Thomas J Mack DPM

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.

• Thomas J Mack, DPM

  • Podiatrist
  • Stickney, IL
  • NPI 1548265689
  NPD Authorized official

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1245415850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21041 W SNOWBERRY LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605446413",
            "telephone_number": "630-390-8360",
            "fax_number": "708-424-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S. ADDISON STREET",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "60106",
            "telephone_number": "630-390-8360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3704 Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "IL",
            "postal_code": "605131624",
            "country_code": "US",
            "telephone_number": "708-387-0633",
            "fax_number": "708-387-0638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BROOKFIELD PODIATRY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOMAS J. MACK",
        "enumeration_date": "2008-01-02",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-390-8360",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003689",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bonner
• Katherine Mary Bozek-Sheehan, MS, CCC-SLP
• Brentwood Family Dental
• Bridgeway of Bensenville Independent Living LLC (Bridgeway Supportive Living Community)
• Bridgeway Senior Living LLC
• Burgos Fuentes Service Corporation
• Miguel Burgos, M.D
• Cecilie Butz
• Jason Alan Castator, M.D.
• Anna Crystal Chaidez, MD

• Podiatrist in Bensenville, IL
• Providers in Bensenville, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.