NPIMap

Organization Active NPI

Andersontiernan, Inc

Doing business as Advanced Foot & Ankle Centers of Illinois

  • Non-Pharmacy Dispensing Site
  • Schaumburg, IL
National Provider Identifier
1720332455
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
ANDERSONTIERNAN, INC
Doing business as
Advanced Foot & Ankle Centers of Illinois
Practice address
455 S Roselle Rd
Suite 100
Schaumburg, IL 60193-2971
Phone
(847) 985-8380
NPI assigned
Nov 2, 2012
Organization subpart
Yes
Parent organization
ANDERSONTIERNAN, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Authorized official

Name
Dr. Dana M. Wisby, DPM
Title
Medical Director
Phone
(847) 985-8380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

455 S Roselle Rd
Suite 100
Schaumburg, IL 60193-2971

Mailing address

2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726
Phone (310) 474-9809

Other names 1

  • Advanced Foot & Ankle Centers of Illinois Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Andersontiernan Inc3 organizations share this tax ID, including this one
Part of
Andersontiernan Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

455 S Roselle Rd
Ste 100
Schaumburg, IL 60193
Phone (847) 352-7295

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1720332455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S ROSELLE RD",
            "address_2": "SUITE 100",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601932971",
            "telephone_number": "847-985-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSONTIERNAN, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANDERSONTIERNAN, INC",
        "enumeration_date": "2012-11-02",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "WISBY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-985-8380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Foot & Ankle Centers of Illinois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.