Organization Active NPI

Rahil Baxamusa DPM

  • Podiatrist
  • Crystal Lake, IL
National Provider Identifier
1265411813
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
RAHIL BAXAMUSA DPM
Practice address
460 Coventry Lane
Ste 103
Crystal Lake, IL 60014-7561
Phone
(815) 455-3788
Fax
(815) 455-4657
NPI assigned
Jan 12, 2006
Last updated
Oct 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Dr. Rahil Baxamuse, DPM
Title
Owner
Phone
(815) 455-3788

Specialties & licenses 1

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

Addresses

Primary practice location

460 Coventry Lane
Ste 103
Crystal Lake, IL 60014-7561

Mailing address

460 Coventry Lane
Ste 103
Crystal Lake, IL 60014-7561
Phone (815) 455-3788

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1265411813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 COVENTRY LANE",
            "address_2": "STE 103",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147561",
            "telephone_number": "815-455-3788",
            "fax_number": "815-455-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 COVENTRY LANE",
            "address_2": "STE 103",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147561",
            "telephone_number": "815-455-3788",
            "fax_number": "815-455-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAHIL BAXAMUSA DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "BAXAMUSE",
        "authorized_official_first_name": "RAHIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-455-3788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.