Active NPI
Alec M Renner, DPM
- Podiatrist
- Chicago, IL
National Provider Identifier
1316624265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 135001201
- Practice address
- 4646 N Marine Dr
Chicago, IL 60640-5759 - Phone
- (773) 564-5738
- NPI assigned
- Jul 3, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 135001201 | IL | Primary |
Addresses
Primary practice location
4646 N Marine Dr
Chicago, IL 60640-5759
Mailing address
4646 N Marine Dr
Chicago, IL 60640-5759
Phone (847) 565-9124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230810001146 | IL | Order and Referring Only - Podiatry | 7810359692 |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5310 N Sheridan Rd
Suite 1
Chicago, IL 60640-2515
Phone (312) 998-0974
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135001201 | IL | MD | Podiatrist |
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.
-
- Podiatrist
- Chicago, IL
- NPI 1588455984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1316624265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 N MARINE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405759",
"telephone_number": "847-565-9124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 N MARINE DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606405759",
"telephone_number": "773-564-5738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNER",
"first_name": "ALEC",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "135001201",
"primary": true
}
],
"identifiers": [],
"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 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.