Organization Active NPI

Preferred Podiatry Group PC

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1316360613
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PREFERRED PODIATRY GROUP PC
Practice address
225 W Washington St Ste 1500
Chicago, IL 60606-3485
Phone
(847) 504-5000
Fax
(847) 504-5015
NPI assigned
Jan 23, 2014
Organization subpart
Yes
Parent organization
PREFERRED PODIATRY GROUP PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Mr. Stevin Kestner
Title
President
Phone
(847) 504-5002

Specialties & licenses 1

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

Addresses

Primary practice location

225 W Washington St Ste 1500
Chicago, IL 60606-3485

Mailing address

PO Box 772294
Detroit, MI 48277-2294
Phone (847) 504-5000

Other identifiers 1

IdentifierTypeStateIssuer
504482407MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040413000340 IL Part B Supplier - Clinic/Group Practice 3971412677 Receives reassigned benefits from 44 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20060814000285 MO Part B Supplier - Clinic/Group Practice 3971412677 Receives reassigned benefits from 17 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Garfield Ridge Medical11 organizations share this tax ID, including this one
Part of
Garfield Ridge Medical

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1316360613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772294",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772294",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063485",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PODIATRY GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREFERRED PODIATRY GROUP PC",
        "enumeration_date": "2014-01-23",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "KESTNER",
        "authorized_official_first_name": "STEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-504-5002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504482407",
            "state": "MO"
        }
    ],
    "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 Nov 18, 2025; 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.