NPIMap

Organization Active NPI

Associated Foot and Ankle Clinics, PC

  • Podiatrist
  • Bourbonnais, IL
National Provider Identifier
1295723435
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
060007405 Issued in IL
Legal business name
ASSOCIATED FOOT AND ANKLE CLINICS, PC
Practice address
11 Briarcliff Prof Ctr
Bourbonnais, IL 60914-1775
Phone
(815) 933-7077
Fax
(815) 933-4430
NPI assigned
Oct 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Authorized official

Name
Dr. Daniel N Benoit, DPMNPI 1124016100
Title
President
Phone
(815) 933-7077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 060007405 IL Primary

Addresses

Primary practice location

11 Briarcliff Prof Ctr
Bourbonnais, IL 60914-1775

Mailing address

301 E Hickory St
Suite 2
Streator, IL 61364-2287
Phone (815) 672-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051111000097 IL Part B Supplier - Clinic/Group Practice 5193744845 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bourbonnais, IL; Streator, IL
O20100930066959 IL DME Supplier - Physician - Podiatry 5193744845 Practice locations: Bourbonnais, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

11 Briarcliff Prof Ctr
Bourbonnais, IL 60914
Phone (815) 933-7077

301 E Hickory St
Streator, IL 61364

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": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1295723435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E HICKORY ST",
            "address_2": "SUITE 2",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642287",
            "telephone_number": "815-672-0280",
            "fax_number": "815-672-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BRIARCLIFF PROF CTR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141775",
            "telephone_number": "815-933-7077",
            "fax_number": "815-933-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FOOT AND ANKLE CLINICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "BENOIT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-933-7077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "060007405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.