Jennifer L Kaleta DPM, LTD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016-004910 Issued in IL

Legal business name

JENNIFER L KALETA DPM, LTD

Doing business as

Near North Podiatry Centers

Practice address

3000 N Halsted St Ste 625
Chicago, IL 60657-5196

Phone

(773) 868-4701

Fax

(773) 868-4702

NPI assigned

Apr 15, 2008

Last updated

Jun 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Diana Walas

Title

Office Maneger

Phone

(773) 868-4701

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Near North Podiatry Centers Doing business as

Locations

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1649444225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131011",
            "telephone_number": "773-868-4701",
            "fax_number": "773-868-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 625",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "773-868-4701",
            "fax_number": "773-868-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER L KALETA DPM, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "WALAS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OFFICE MANEGER",
        "authorized_official_telephone_number": "773-868-4701",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016-004910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004910",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "207100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1633808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5048120002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Near North Podiatry Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.