Northwest Podiatry Center

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

016-002778 Issued in IL

Legal business name

NORTHWEST PODIATRY CENTER

Practice address

3254 Sycamore Rd
Dekalb, IL 60115-9621

Phone

(815) 756-9491

Fax

(815) 756-9442

NPI assigned

Jun 3, 2015

Last updated

Apr 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory C. Bryniczka, DPM

Title

President

Phone

(815) 756-9491

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1356721500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3254 SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159621",
            "telephone_number": "815-756-9491",
            "fax_number": "815-756-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3254 SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159621",
            "telephone_number": "815-756-9491",
            "fax_number": "815-756-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PODIATRY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "BRYNICZKA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-756-9491",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "016-002778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Illinois University (Northern Illinois University Sports Medicine)
• Northern Illinois University (Speech and Hearing clinic)
• Northern Illinois University Health Services
• Northern Illinois University-Physical Therapy
• Northern Rehabilitation & Sports Medicine Associates, Inc.
• Northwestern Medicine
• Northwestern Memorial Healthcare
• David J Nowak, CRNA
• James Skylar O'Brien, DDS
• Tara Kelsi O'Connell, RD

• Durable Medical Equipment & Medical Supplies in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.