Gary J Rogers DPM PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016004888 Issued in IL

Legal business name

GARY J ROGERS DPM PC

Practice address

1919 Lake Ave Ste a
Wilmette, IL 60091-1422

Phone

(847) 256-4434

Fax

(847) 256-4437

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Gary Rogers, DPMNPI 1558356097

Title

Owner

Phone

(847) 256-4434

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ROGERS PODIATRY DPM Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Gary John Rogers, DPM

  • Podiatrist
  • Wilmette, IL
  • NPI 1558356097

  O20100930031615

  Same enrollment

Tax ID family

Gary Rogers DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gary Rogers DPM

  • Podiatrist
  • Wilmette, IL
  • NPI 1508049404
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary John Rogers, DPM

  • Podiatrist
  • Wilmette, IL
  • NPI 1558356097
  Medicare reassignment NPD Authorized official
• Carle E Rollins, DPM

  • Podiatrist
  • Wilmette, IL
  • NPI 1790872786
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1487879797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 LAKE AVE STE A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911422",
            "telephone_number": "847-256-4434",
            "fax_number": "847-256-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LAKE AVE STE A",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911422",
            "telephone_number": "847-256-4434",
            "fax_number": "847-256-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY J ROGERS DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-256-4434",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0021622507",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROGERS PODIATRY DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neil R Friedman, M.D.
• Elena Frishman, PHD
• Alene Frost
• Marilyn Cecelia Fuller, P.T.
• Alexis Ganzer
• Gary Rogers DPM
• Kyle Gaughan
• Richard Gauthier, LCSW
• Sara Rochelle Gawenda
• Elizabeth Therese Gelfman, MMSC, CGC

• Podiatrist in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.