Bandyk Podiatry

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016-004010 Issued in IL

Legal business name

BANDYK PODIATRY

Doing business as

Bandyk Podiatry

Practice address

18503 Torrence Ave
Lansing, IL 60438

Phone

(708) 474-1900

Fax

(708) 474-1037

NPI assigned

Mar 31, 2008

Last updated

Jun 11, 2008By 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

Mr. Robert Jon BandykNPI 1679587786

Title

Dr

Phone

(708) 474-1900

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Bandyk Podiatry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Bandyk, DPM

  • Podiatrist
  • Lansing, IL
  • NPI 1679587786
  NPD (past) Authorized official

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1669644548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 TORRENCE AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "60438",
            "telephone_number": "708-474-1900",
            "fax_number": "708-474-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 TORRENCE AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "60438",
            "telephone_number": "708-474-1900",
            "fax_number": "708-474-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANDYK PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "BANDYK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "708-474-1900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016-004010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004010",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "4800148821",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "6000 1 555",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bandyk Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.