Individual provider Active NPI

Cayetano Puzon, DPM

  • Primary Podiatric Medicine Podiatrist
  • Chicago, IL
National Provider Identifier
1265651905
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
016004484 Issued in IL
Practice address
5310 N Sheridan Rd
Chicago, IL 60640-2514
Phone
(773) 769-8165
Fax
(773) 769-8167
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 016004484 IL Primary

Addresses

Primary practice location

5310 N Sheridan Rd
Chicago, IL 60640-2514

Mailing address

2 E Oak St Apt 3601
Chicago, IL 60611-6203
Phone (312) 642-2236

Other identifiers 1

IdentifierTypeStateIssuer
016004484MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004484ILMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Lopez Cordero, M.D., S.C. PastSince Feb 20, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265651905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E OAK ST APT 3601",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116203",
            "telephone_number": "312-642-2236",
            "fax_number": "312-642-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402514",
            "telephone_number": "773-769-8165",
            "fax_number": "773-769-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUZON",
        "first_name": "CAYETANO",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016004484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004484",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.