Premier Foot and Ankle of Illinois, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016.005608 Issued in IL

Legal business name

PREMIER FOOT AND ANKLE OF ILLINOIS, PC

Practice address

6810 State Route 162
Suite 20
Maryville, IL 62062-8587

Phone

(618) 288-2835

Fax

(618) 288-6162

NPI assigned

Jun 30, 2014

Last updated

Nov 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gabriel Cardenas Jr., DPMNPI 1043521719

Title

Owner/Podiatrist

Phone

(618) 288-2835

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gabriel Cardenas Jr., D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Maryville, IL
  • NPI 1043521719
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1467867234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "SUITE 20",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628587",
            "telephone_number": "618-288-2835",
            "fax_number": "618-288-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "SUITE 20",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628587",
            "telephone_number": "618-288-2835",
            "fax_number": "618-288-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FOOT AND ANKLE OF ILLINOIS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "CARDENAS",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "618-288-2835",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP",
            "identifier": "F100153987",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danuta J Pikul, MD
• Marcus A. Piper, M.S., L.C.P.C.
• Samantha Jean Pisarski, PA-C
• Thena Gidget Poteat, M.D.
• James S Powell, MD
• Progressive Health Care for Women, LTD
• Psychiatric Urgent Care LLC
• Ashlee K Pugh, COTA/L
• Henry Purcell, M.D.
• Adam Quitmeyer

• Foot & Ankle Surgery Podiatrist in Maryville, IL
• Providers in Maryville, 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 Nov 18, 2016; 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.