Mercado Foot & Ankle Clinic West LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016004238 Issued in IL

Legal business name

MERCADO FOOT & ANKLE CLINIC WEST LLC

Practice address

24024 Brancaster Dr
Naperville, IL 60564-8044

Phone

(630) 922-7722

Fax

(630) 922-7727

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. O. Kent Mercado, D.P.M.

Title

Director

Phone

(630) 922-7722

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1447360896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24024 BRANCASTER DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648044",
            "telephone_number": "630-922-7722",
            "fax_number": "630-922-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24024 BRANCASTER DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648044",
            "telephone_number": "630-922-7722",
            "fax_number": "630-922-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCADO FOOT & ANKLE CLINIC WEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "O. KENT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-922-7722",
        "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": "016004238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR DMERC #",
            "identifier": "5180850001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004238",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP #",
            "identifier": "CI5229",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "60001691",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Marie Menges, LCPC, CADC
• Alexis Menias, PA-C
• Shreevidya V Menon, D.O.
• Myra Mensah
• Cynthia Ann Menza, LCPC
• Selena Mercado
• Melanie Mercer
• Katherine Marie Mercy, MD
• Meredith Gantos DDS LLC
• Meredith Mahoney, PSYD PLLC

• Foot & Ankle Surgery Podiatrist in Naperville, IL
• Providers in Naperville, 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 Mar 23, 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.