NPIMap

Organization Active NPI

Il Foot & Ankle Clinic Medical Corp

  • Foot & Ankle Surgery Podiatrist
  • Des Plaines, IL
National Provider Identifier
1295925899
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-005284 Issued in IL
Legal business name
IL FOOT & ANKLE CLINIC MEDICAL CORP
Practice address
1400 E Golf Rd Ste 201
Des Plaines, IL 60016-8821
Phone
(847) 298-3338
Fax
(847) 298-3334
NPI assigned
Jul 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Authorized official

Name
Dr. Alexander YanovskiyNPI 1992724488
Title
President
Phone
(847) 298-3338

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016-005284 IL Primary

Addresses

Primary practice location

1400 E Golf Rd Ste 201
Des Plaines, IL 60016-8821

Mailing address

1400 E Golf Rd Ste 201
Des Plaines, IL 60016-8821
Phone (773) 614-3302

Other identifiers 1

IdentifierTypeStateIssuer
016005284MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ANLI.INC2014@GMAIL.COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, LA, WI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20071005000762 IL Part B Supplier - Clinic/Group Practice 8820183742 Receives reassigned benefits from 8 practitioners
Practice locations: Chicago, IL; Des Plaines, IL; Niles, IL
O20100930029775 IL DME Supplier - Physician - Podiatry 8820183742 Practice locations: Des Plaines, IL
O20260420001769 LA Part B Supplier - Clinic/Group Practice 8820183742 Practice locations: Arcadia, LA
O20260506002274 WI Part B Supplier - Clinic/Group Practice 8820183742 Receives reassigned benefits from 1 practitioner
Practice locations: Milwaukee, WI

National Provider Directory

National Provider Directory

Locations

2958 W Devon Ave
Chicago, IL 60659
Phone (773) 274-9100

1400 E Golf Rd
Ste 201
Des Plaines, IL 60016
Phone (847) 298-3338

Practitioners & affiliated clinicians

Practitioners 10

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": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1295925899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E GOLF RD STE 201",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600168821",
            "telephone_number": "773-614-3302",
            "fax_number": "847-906-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E GOLF RD STE 201",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600168821",
            "telephone_number": "847-298-3338",
            "fax_number": "847-298-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IL FOOT & ANKLE CLINIC MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "YANOVSKIY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-298-3338",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-005284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005284",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ANLI.INC2014@GMAIL.COM",
            "affiliation": "N",
            "address_1": "1400 E Golf Rd Ste 201",
            "city": "Des Plaines",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600168821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.