NPIMap

Organization Active NPI

Ramin Ghazizadeh LLC

  • Foot & Ankle Surgery Podiatrist
  • Park Forest, IL
National Provider Identifier
1366083032
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
RAMIN GHAZIZADEH LLC
Practice address
231 Main St
Park Forest, IL 60466-2097
Phone
(708) 748-3338
Fax
(708) 748-4332
NPI assigned
Oct 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Authorized official

Name
Ramin Ghazizadeh, DPM
Title
Owner/Ceo
Phone
(312) 330-4574

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

231 Main St
Park Forest, IL 60466-2097

Mailing address

231 Main St
Park Forest, IL 60466-2097
Phone (708) 748-3338

Other identifiers 1

IdentifierTypeStateIssuer
016005783MedicaidIL

Other names 1

  • Ramin Ghazizadeh DPM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Park Forest Podiatry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1366083032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662097",
            "telephone_number": "708-748-3338",
            "fax_number": "708-748-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAIN ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662097",
            "telephone_number": "708-748-3338",
            "fax_number": "708-748-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAMIN GHAZIZADEH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "GHAZIZADEH",
        "authorized_official_first_name": "RAMIN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "312-330-4574",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005783",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ramin Ghazizadeh DPM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ramin Ghazizadeh DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.