NPIMap

Organization Active NPI

Mercado Foot and Ankle Clinics

  • Podiatrist
  • Richton Park, IL
National Provider Identifier
1265430730
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MERCADO FOOT AND ANKLE CLINICS
Practice address
4143 Sauk TRL
Richton Park, IL 60471-1253
Phone
(708) 748-3337
Fax
(708) 747-3338
NPI assigned
Jul 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Michael James Smith, DPM
Title
Podiatrist/Owner/Partner
Phone
(708) 748-3337

Specialties & licenses 1

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

Addresses

Primary practice location

4143 Sauk TRL
Richton Park, IL 60471-1253

Mailing address

4143 Sauk TRL
Richton Park, IL 60471-1253
Phone (708) 748-3337

Other identifiers 3

IdentifierTypeStateIssuer
1634248OtherBCBS
705352LOtherAETNA
P00145458OtherGBA RAILROAD

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.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1265430730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4143 SAUK TRL",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711253",
            "telephone_number": "708-748-3337",
            "fax_number": "708-747-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4143 SAUK TRL",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711253",
            "telephone_number": "708-748-3337",
            "fax_number": "708-747-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCADO FOOT AND ANKLE CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PODIATRIST/OWNER/PARTNER",
        "authorized_official_telephone_number": "708-748-3337",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1634248",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "705352L",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GBA RAILROAD",
            "identifier": "P00145458",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richton Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.