NPIMap

Organization Active NPI

KV Foot and Ankle PC

  • Podiatrist
  • Lisle, IL
National Provider Identifier
1609316686
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016005612 Issued in IL
Legal business name
KV FOOT AND ANKLE PC
Practice address
629 Columbine Ave
Lisle, IL 60532-2711
Phone
(708) 341-6428
NPI assigned
Feb 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Authorized official

Name
Dr. Sarah Ann Summer Matouk, DPM
Title
President
Phone
(708) 341-6428

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 016005612 IL Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016005612 IL

Addresses

Primary practice location

629 Columbine Ave
Lisle, IL 60532-2711

Mailing address

629 Columbine Ave
Lisle, IL 60532-2711
Phone (708) 341-6428

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507248000000",
    "number": "1609316686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 COLUMBINE AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322711",
            "telephone_number": "708-341-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 COLUMBINE AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322711",
            "telephone_number": "708-341-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KV FOOT AND ANKLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-10-06",
        "status": "A",
        "authorized_official_last_name": "MATOUK",
        "authorized_official_first_name": "SARAH ANN",
        "authorized_official_middle_name": "SUMMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-341-6428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005612",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.