Dezanek Podiatry Center LTD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016003970 Issued in IL

Legal business name

DEZANEK PODIATRY CENTER LTD

Practice address

5916 W Higgins Ave
Chicago, IL 60630-1905

Phone

(773) 283-1911

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Charles Dezanek, DPMNPI 1447449798

Title

Corp President

Phone

(773) 283-1911

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Robert C Dezanek DPM Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Charles Dezanek, DPM

  • Podiatrist
  • Chicago, IL
  • NPI 1447449798
  Medicare reassignment NPD Authorized official
• Lori Jean De Zanek, R.D.

  • Registered Dietitian
  • Rockford, IL
  • NPI 1487733325
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419552000000",
    "number": "1407934888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5916 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301905",
            "telephone_number": "773-283-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5916 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301905",
            "telephone_number": "773-283-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEZANEK PODIATRY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-12-26",
        "status": "A",
        "authorized_official_last_name": "DEZANEK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CORP PRESIDENT",
        "authorized_official_telephone_number": "773-283-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0060001570",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3394649896063002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480009595",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert C Dezanek DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren A Dewitt
• Dewolfe Aesthetic Services SC
• Kally Ann Dey, DO
• Rahul Dey
• Shirin Ann Dey, MD
• Robert Charles Dezanek, DPM
• Daniel John Deziel, M.D.
• Gregory John Dezulskis, LCPC
• Catherine Shannon Dezynski, WHNP, CNM
• Dfined Beauty LLC

• Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; 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.