Carlos F Smith DPM PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016004833 Issued in IL

Legal business name

CARLOS F SMITH DPM PC

Practice address

711 W North Ave
Ste 210
Chicago, IL 60610-1042

Phone

(312) 642-3440

Fax

(312) 642-4319

NPI assigned

Sep 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carlos Frederick Smith, DPMNPI 1033190079

Title

President

Phone

(312) 642-3440

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Carlos Frederick Smith, DPM

  • Podiatrist
  • Chicago, IL
  • NPI 1033190079
  Medicare reassignment Authorized official
• Qeena C Woodard, DPM

  • Podiatrist
  • North Chicago, IL
  • NPI 1548210339
  Medicare reassignment NPD

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1609063155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W NORTH AVE",
            "address_2": "STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101042",
            "telephone_number": "312-642-3440",
            "fax_number": "312-642-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W NORTH AVE",
            "address_2": "STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101042",
            "telephone_number": "312-642-3440",
            "fax_number": "312-642-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS F SMITH DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-642-3440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "480035349",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004833",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashionda Carlisle
• Timothy Clifford Carll, MD
• Amanda Carlo, NP
• Andrew David Carlo, MD, MPH
• Carlos F Pedrera MD SC
• Carlos H Zambrano MD LLC
• Carlos Ortega MD SC (Boffa Surgical Group LLC)
• Arlene Carlos, MS
• Christine Carlos
• Jessica Carlos, LCSW

• Foot & Ankle Surgery Podiatrist in Chicago, IL
• Providers in Chicago, 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 Apr 27, 2011; 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.