Philip Forni, DPM
Individual provider Active NPI Podiatrist · Roselle, IL
NPI 1699897264 · NPPES record last updated Mar 13, 2017
Key facts
- NPI
- 1699897264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- 16-2960 (IL)
- Practice address
- 825 N Roselle Rd
Roselle, IL 60172-4212 - Phone
- (630) 582-1100
- Fax
- (630) 582-1165
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16-2960 | IL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Podiatric Management Systems LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 16-2960 | IL | Yes |
Addresses
Primary practice location
825 N Roselle Rd
Roselle, IL 60172-4212
Mailing address
PO Box 72116
Roselle, IL 60172-0116
Phone (630) 582-1100
Other providers in Roselle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.