Active NPI
Tara L Sakevich, DPM
- Podiatrist
- Chicago, IL
National Provider Identifier
1649253097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016005128
- Practice address
- 820 S Damen Ave
7TH Floor - Podiatry Department
Chicago, IL 60612-3728 - Phone
- (312) 569-7264
- NPI assigned
- Nov 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 016005128 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
7TH Floor - Podiatry Department
Chicago, IL 60612-3728
Mailing address
8320 S County Line Rd
7TH Floor - Podiatry Department
Burr Ridge, IL 60527-6376
Phone (773) 372-3282
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016-005128 | Medicaid | IL | |
| 7346657 | Other | IL | AETNA |
| P00235061 | Other | IL | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016005128 | IL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foot & Ankle Associates LTD | Podiatrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Podiatrist
- Oak Lawn, IL
- NPI 1407837958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1649253097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8320 S COUNTY LINE RD",
"address_2": "7TH FLOOR - PODIATRY DEPARTMENT",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276376",
"telephone_number": "773-372-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"address_2": "7TH FLOOR - PODIATRY DEPARTMENT",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-7264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAKEVICH",
"first_name": "TARA",
"middle_name": "L",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-21",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016005128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016-005128",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7346657",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00235061",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.