Individual provider Active NPI

Donald McGovern, CPO

  • Orthotist
  • Chicago, IL
National Provider Identifier
1467783217
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
213.000039 Issued in IL
Practice address
345 E Superior St
Chicago, IL 60611-2654
Phone
(312) 238-1000
NPI assigned
Jan 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X 213.000039 IL Primary
Prosthetist 224P00000X 211.000026 IL

Addresses

Primary practice location

345 E Superior St
Chicago, IL 60611-2654

Mailing address

4039 Ellington Ave
Western Springs, IL 60558-1206
Phone (708) 246-1835

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
213.000039ILMDOrthotist
211.000026ILMDProsthetist

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1467783217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 ELLINGTON AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581206",
            "telephone_number": "708-246-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112654",
            "telephone_number": "312-238-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "DONALD",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "IL",
            "license": "213.000039",
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "IL",
            "license": "211.000026",
            "primary": false
        }
    ],
    "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 Jan 19, 2010; 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.