Individual provider Active NPI

Raymond Henry Hanzelin, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Berwyn, IL
National Provider Identifier
1477626166
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
162862 Issued in IL
Practice address
6845 Stanley Ave
Berwyn, IL 60402-3041
Phone
(087) 885-2327
Fax
(708) 788-3618
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 162862 IL Primary

Addresses

Primary practice location

6845 Stanley Ave
Berwyn, IL 60402-3041

Mailing address

6845 Stanley Ave
Berwyn, IL 60402-3041
Phone (087) 885-2327

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090921000458 IL Practitioner - Podiatry 6204982036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camilleri Medical Center LTDGroup PAC ID 3779478847, 3 clinicians

Practice addresses (Care Compare)

6845 Stanley Ave
Berwyn, IL 60402-3041
Phone (708) 788-5232

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
162862ILMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Camilleri Medical Center LTD Primary Podiatric Medicine CurrentSince Mar 24, 2025 Accepting new patients

Locations

6845 Stanley Ave
Berwyn, IL 60402
Phone (708) 788-5232

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1477626166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6845 STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023041",
            "telephone_number": "087-885-2327",
            "fax_number": "708-788-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6845 STANLEY AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023041",
            "telephone_number": "087-885-2327",
            "fax_number": "708-788-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANZELIN",
        "first_name": "RAYMOND",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "162862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.