NPIMap

Organization Active NPI

Michael a. Wood, D.P.M., P.C.

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1447360532
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
060009368 Issued in IL
Legal business name
MICHAEL A. WOOD, D.P.M., P.C.
Practice address
10528 S Ewing Ave
Chicago, IL 60617-6219
Phone
(773) 375-0791
Fax
(773) 734-2723
NPI assigned
Aug 30, 2006
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
Dr. Michael Andrew Wood, D.P.M.NPI 1740222694
Title
Podiatrist, President
Phone
(708) 418-5551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 060009368 IL Primary

Addresses

Primary practice location

10528 S Ewing Ave
Chicago, IL 60617-6219

Mailing address

PO Box 49
Lansing, IL 60438-0049
Phone (708) 895-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051104000344 IL Part B Supplier - Clinic/Group Practice 2860410131 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Lansing, IL
O20071030000192 IN Part B Supplier - Clinic/Group Practice 2860410131 Receives reassigned benefits from 1 practitioner
Practice locations: Munster, IN

National Provider Directory

National Provider Directory

Locations

10528 S Ewing Ave
Chicago, IL 60617
Phone (708) 375-0791

1005 Essington Rd
Joliet, IL 60435
Phone (815) 730-8200

3224 Ridge Rd
Ste 101
Lansing, IL 60438
Phone (708) 418-5551

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1447360532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604380049",
            "telephone_number": "708-895-9000",
            "fax_number": "708-418-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10528 S EWING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176219",
            "telephone_number": "773-375-0791",
            "fax_number": "773-734-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A. WOOD, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PODIATRIST, PRESIDENT",
        "authorized_official_telephone_number": "708-418-5551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "060009368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, 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.