Robert Charles Dezanek, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

Practice address

5916 W Higgins Ave
Chicago, IL 60630-1905

Phone

(773) 283-1911

NPI assigned

Oct 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dezanek Podiatry Center LTD

  • Podiatrist
  • Chicago, IL
  • NPI 1407934888
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1447449798",
    "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": {
        "last_name": "DEZANEK",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0060001570",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dewolfe Aesthetic Services SC
• Kally Ann Dey, DO
• Rahul Dey
• Shirin Ann Dey, MD
• Dezanek Podiatry Center LTD
• Daniel John Deziel, M.D.
• Gregory John Dezulskis, LCPC
• Catherine Shannon Dezynski, WHNP, CNM
• Dfined Beauty LLC
• DFM Wellness Alliance, 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 Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.