Individual provider Active NPI

Kaitlyn Nicole Vu, DPM

  • Foot & Ankle Surgery Podiatrist
  • Libertyville, IL
National Provider Identifier
1649910696
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016006129 Issued in IL
Practice address
1870 W Winchester Rd
Libertyville, IL 60048-5358
Phone
(847) 816-3156
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016006129 IL Primary

Addresses

Primary practice location

1870 W Winchester Rd
Libertyville, IL 60048-5358

Mailing address

500 Burlington Cir
Wheeling, IL 60090-4114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250818002873 IL Practitioner - Podiatry 6204335193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Gail Kwiecinski DPM P CGroup PAC ID 9436332418, 3 clinicians

Practice addresses (Care Compare)

1870 W Winchester Rd
Suite 246
Libertyville, IL 60048-5360
Phone (847) 816-3156

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Encompass Health Rehab Institute of Libertyville Inpatient rehabilitation facility, Libertyville, IL, CCN 143031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue143
Removal or shaving of skin growth74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016006129ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Libertyville Podiatry PC Podiatrist CurrentSince Jul 1, 2025 Accepting new patients

Locations

1870 W Winchester Rd
Ste 246
Libertyville, IL 60048
Phone (847) 362-5344

1870 W Winchester Rd
Libertyville, IL 60048
Phone (847) 816-7495

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1649910696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BURLINGTON CIR",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600904114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485358",
            "telephone_number": "847-816-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016006129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.