Individual provider Active NPI

Flavio Cordano, DPM

  • Foot & Ankle Surgery Podiatrist
  • Rockford, IL
National Provider Identifier
1427059237
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
004609 Issued in IL
Practice address
534 Roxbury Rd
Rockford, IL 61107-5076
Phone
(815) 226-7100
Fax
(815) 381-0776
NPI assigned
Aug 2, 2005
Reactivated
Apr 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 004609 IL Primary

Addresses

Primary practice location

534 Roxbury Rd
Rockford, IL 61107-5076

Mailing address

534 Roxbury Rd
Rockford, IL 61107-5076
Phone (815) 226-7100

Other identifiers 1

IdentifierTypeStateIssuer
016-004609MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004609ILMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1427059237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-226-7100",
            "fax_number": "815-381-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-226-7100",
            "fax_number": "815-381-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDANO",
        "first_name": "FLAVIO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2015-02-13",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "004609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016-004609",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.