Active NPI
Advanced Foot and Ankle Surgeons, Inc.
- Foot & Ankle Surgery Podiatrist
- Yorkville, IL
National Provider Identifier
1528394343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 016005351
- Legal business name
- ADVANCED FOOT AND ANKLE SURGEONS, INC.
- Practice address
- 215 Hillcrest Ave
Suite B
Yorkville, IL 60560-1366 - Phone
- (630) 352-3700
- Fax
- (815) 986-6062
- NPI assigned
- Oct 29, 2009
- Last updated
- May 8, 2015
- Organization subpart
- Yes
- Parent organization
- ADVANCED FOOT AND ANKLE SURGEONS, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Douglas J Pacaccio, DPM
- Title
- President
- Phone
- (630) 352-3700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016005351 | IL | Primary |
Addresses
Primary practice location
215 Hillcrest Ave
Suite B
Yorkville, IL 60560-1366
Mailing address
2180 Oakland Dr
Unit a
Sycamore, IL 60178-3122
Phone (815) 669-4811
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013005867 | Other | IL | INDIVIDUAL NPI |
| 016005351 | Medicaid | IL |
National Provider Directory
National Provider Directory- Part of
- Advanced Foot and Ankle Surgeons Inc
Practitioners & affiliated clinicians
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256774400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1431043200000",
"number": "1528394343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 OAKLAND DR",
"address_2": "UNIT A",
"city": "SYCAMORE",
"state": "IL",
"postal_code": "601783122",
"telephone_number": "815-669-4811",
"fax_number": "815-986-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 HILLCREST AVE",
"address_2": "SUITE B",
"city": "YORKVILLE",
"state": "IL",
"postal_code": "605601366",
"telephone_number": "630-352-3700",
"fax_number": "815-986-6062"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED FOOT AND ANKLE SURGEONS, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADVANCED FOOT AND ANKLE SURGEONS, INC",
"enumeration_date": "2009-10-29",
"last_updated": "2015-05-08",
"status": "A",
"authorized_official_last_name": "PACACCIO",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-352-3700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "016005351",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI",
"identifier": "1013005867",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016005351",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yorkville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.