Northwest Podiatry Center

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

016-002778 Issued in IL

Legal business name

NORTHWEST PODIATRY CENTER

Practice address

2124 Ogden Ave
Suite 101
Aurora, IL 60504-7514

Phone

(630) 585-8087

Fax

(630) 585-8024

NPI assigned

Jun 2, 2015

Last updated

Apr 25, 2016By 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

Gregory C. Bryniczka, DPM

Title

President

Phone

(630) 830-2155

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1417337825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 OGDEN AVE",
            "address_2": "SUITE 101",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047514",
            "telephone_number": "630-585-8087",
            "fax_number": "630-585-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 OGDEN AVE",
            "address_2": "SUITE 101",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047514",
            "telephone_number": "630-585-8087",
            "fax_number": "630-585-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PODIATRY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "BRYNICZKA",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-830-2155",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "016-002778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Aurora, IL
• Providers in Aurora, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.