Organization Active NPI

Foot and Ankle Med/Surg

  • Foot & Ankle Surgery Podiatrist
  • Normal, IL
National Provider Identifier
1467622571
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT AND ANKLE MED/SURG
Practice address
1607 Visa Dr Ste 2a
Normal, IL 61761-6160
Phone
(309) 452-7112
NPI assigned
Mar 4, 2008
Last updated
Mar 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Carl John Cortese, D.P.M.
Title
President
Phone
(309) 452-7112

Specialties & licenses 1

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

Addresses

Primary practice location

1607 Visa Dr Ste 2a
Normal, IL 61761-6160

Mailing address

1607 Visa Dr Ste 2a
Normal, IL 61761-6160
Phone (309) 452-7112

National Provider Directory

National Provider Directory

Locations

1607 Visa Dr
Ste 2A
Normal, IL 61761
Phone (309) 452-3000

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1467622571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 VISA DR STE 2A",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616160",
            "telephone_number": "309-452-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 VISA DR STE 2A",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616160",
            "telephone_number": "309-452-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE MED/SURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "CORTESE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-452-7112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.