Organization Active NPI

Tri-County Foot & Ankle Centers LTD

  • Foot & Ankle Surgery Podiatrist
  • McHenry, IL
National Provider Identifier
1376715870
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
TRI-COUNTY FOOT & ANKLE CENTERS LTD
Practice address
4310 W Crystal Lake Rd Ste F
McHenry, IL 60050-4282
Phone
(815) 363-3223
Fax
(815) 353-3240
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Dr. Iqbal KhanNPI 1053341305
Title
President
Phone
(815) 363-3223

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 Primary

Addresses

Primary practice location

4310 W Crystal Lake Rd Ste F
McHenry, IL 60050-4282

Mailing address

4310 W Crystal Lake Rd Ste F
McHenry, IL 60050-4282
Phone (815) 363-3223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110408000723 WI Part B Supplier - Clinic/Group Practice 3870702285 Receives reassigned benefits from 2 practitioners
Practice locations: Kenosha, WI
O20110518000308 IL Part B Supplier - Clinic/Group Practice 3870702285 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Villa, IL; McHenry, IL

National Provider Directory

National Provider Directory

Locations

36735 N Il Route 83
Ste D1
Lake Villa, IL 60046
Phone (847) 356-3338

7611 Pershing Blvd
Ste F
Kenosha, WI 53142
Phone (262) 697-3668

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": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1376715870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 W CRYSTAL LAKE RD STE F",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504282",
            "telephone_number": "815-363-3223",
            "fax_number": "815-353-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 W CRYSTAL LAKE RD STE F",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504282",
            "telephone_number": "815-363-3223",
            "fax_number": "815-353-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY FOOT & ANKLE CENTERS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "IQBAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-363-3223",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.