McDermott Podiatry of Joliet PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016004034 Issued in IL

Legal business name

MCDERMOTT PODIATRY OF JOLIET PC

Doing business as

McDermott Podiatry of Joliet

Practice address

14532 John Humphrey Dr
Orland Park, IL 60462-2640

Phone

(708) 403-1611

Fax

(708) 403-1650

NPI assigned

Dec 8, 2010

Organization subpart

No

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

Authorized official

Name

Michael McDermott, DPMNPI 1538119987

Title

Owner

Phone

(708) 403-1611

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• McDermott Podiatry of Joliet Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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

• Michael J McDermott, DPM

  • Podiatrist
  • Orland Park, IL
  • NPI 1538119987
  Medicare reassignment Authorized official
• Fraterno Lemus, M. D.

  • Neurology Physician
  • Orland Park, IL
  • NPI 1114969904
  NPD (past)
• Nicholas Parrilli, DPM

  • Podiatrist
  • Downers Grove, IL
  • NPI 1558310904
  NPD (past)

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1598068850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14532 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622640",
            "telephone_number": "708-403-1611",
            "fax_number": "708-403-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14532 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622640",
            "telephone_number": "708-403-1611",
            "fax_number": "708-403-1650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Essington Rd",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604352801",
            "country_code": "US",
            "telephone_number": "815-425-3812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16250 Louis Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "South Holland",
            "state": "IL",
            "postal_code": "604732273",
            "country_code": "US",
            "telephone_number": "708-339-8900",
            "fax_number": "708-362-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCDERMOTT PODIATRY OF JOLIET PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2021-12-15",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-403-1611",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL4307",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004034",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "docmac11@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "Medisoft software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14532 John Humphrey Dr",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604622640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "McDermott Podiatry of Joliet",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McDermott Podiatry of Joliet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon D McCarthy, OTR
• Destini McConville
• Maureen Anne McConville
• Joyce McCullough, OTR
• Lori Ann McCurdy, DT
• Tracy Ann McDermott Trevino, APRN, FNP-C
• Michael J McDermott, DPM
• Catherine Ann McDoniel, D.O.
• Kristin McErlean, M.S. CCC-SLP
• Rochelle J McGhee, M.A., L.C.P.C.

• Foot & Ankle Surgery Podiatrist in Orland Park, IL
• Providers in Orland Park, 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 Dec 15, 2021; 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.