Organization Active NPI

Mercado Foot and Ankle Clinics

  • Foot & Ankle Surgery Podiatrist
  • Berwyn, IL
National Provider Identifier
1659510865
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016004482 Issued in IL
Legal business name
MERCADO FOOT AND ANKLE CLINICS
Practice address
3245 Grove Ave Ste 101102
Berwyn, IL 60402-3474
Phone
(708) 484-3599
Fax
(708) 749-0727
NPI assigned
Feb 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Authorized official

Name
Cynthia M Mercado, DPMNPI 1760588891
Title
DPM
Phone
(708) 484-3599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016004482 IL Primary

Addresses

Primary practice location

3245 Grove Ave Ste 101102
Berwyn, IL 60402-3474

Mailing address

3245 Grove Ave Ste 101102
Berwyn, IL 60402-3474
Phone (708) 484-3599

Other identifiers 1

IdentifierTypeStateIssuer
016004482MedicaidIL

National Provider Directory

National Provider Directory

Locations

3245 Grove Ave
Ste 101102
Berwyn, IL 60402
Phone (708) 484-3599

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1659510865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE STE 101102",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023474",
            "telephone_number": "708-484-3599",
            "fax_number": "708-749-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE STE 101102",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023474",
            "telephone_number": "708-484-3599",
            "fax_number": "708-749-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCADO FOOT AND ANKLE CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "708-484-3599",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004482",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.