Organization Active NPI

Raymond H Hanzelin DPM LTD

  • Primary Podiatric Medicine Podiatrist
  • Lyons, IL
National Provider Identifier
1386923092
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
RAYMOND H HANZELIN DPM LTD
Practice address
7851 Ogden Ave
Lyons, IL 60534-1320
Phone
(708) 442-4901
NPI assigned
Aug 11, 2011
Last updated
Aug 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Authorized official

Name
Raymond H Hanzelin, DPM
Title
President
Phone
(708) 442-4901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X NU Primary

Addresses

Primary practice location

7851 Ogden Ave
Lyons, IL 60534-1320

Mailing address

7851 Ogden Ave
Lyons, IL 60534-1320
Phone (708) 442-4901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120321000857 IL Part B Supplier - Clinic/Group Practice 6103086590 Practice locations: Berwyn, IL; Burr Ridge, IL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1386923092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7851 OGDEN AVE",
            "city": "LYONS",
            "state": "IL",
            "postal_code": "605341320",
            "telephone_number": "708-442-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7851 OGDEN AVE",
            "city": "LYONS",
            "state": "IL",
            "postal_code": "605341320",
            "telephone_number": "708-442-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND H HANZELIN DPM LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "HANZELIN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-442-4901",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.