Bolingbrook Foot Specialists LTD

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016002706 Issued in IL

Legal business name

BOLINGBROOK FOOT SPECIALISTS LTD

Practice address

454 W Boughton Road
Bolingbrook, IL 60440-1378

Phone

(630) 759-4411

Fax

(630) 759-6063

NPI assigned

Nov 27, 2006

Last updated

Sep 30, 2014By 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

Dr. Jeffrey M Mackler, DPMNPI 1215076617

Title

Owner

Phone

(630) 759-4411

Specialties & licenses 1

Addresses

Other names 1

• Jeffrey M Mackler DPM Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey M Mackler, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bolingbrook, IL
  • NPI 1215076617
  Authorized official Same address or phone
• Sunita Anantaneni, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chesterfield, MO
  • NPI 1134296643
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1396811824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 W BOUGHTON RD SUITE A",
            "address_2": "BOLINGBROOK FOOT SPECIALISTS",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401378",
            "telephone_number": "630-759-4411",
            "fax_number": "630-759-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 W BOUGHTON ROAD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401378",
            "telephone_number": "630-759-4411",
            "fax_number": "630-759-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLINGBROOK FOOT SPECIALISTS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "MACKLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-759-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016002706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey M Mackler DPM",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.