NPIMap

Organization Active NPI

Podiatry Service of America Corp

  • Foot & Ankle Surgery Podiatrist
  • Wheeling, IL
National Provider Identifier
1720501257
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PODIATRY SERVICE OF AMERICA CORP
Practice address
31 W Dundee Rd
Wheeling, IL 60090-4863
Phone
(847) 215-1525
NPI assigned
Jul 17, 2017
Last updated
Aug 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Authorized official

Name
Dr. Paul Potach, D.P.M.NPI 1073627410
Title
President
Phone
(847) 215-1525

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 IL Primary

Addresses

Primary practice location

31 W Dundee Rd
Wheeling, IL 60090-4863

Mailing address

31 West Dundee
Wheeling, IL 60090
Phone (847) 215-1525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170901002408 IL Part B Supplier - Clinic/Group Practice 2668745282 Receives reassigned benefits from 10 practitioners
Practice locations: Aurora, IL; Chicago, IL; Cicero, IL; Crestwood, IL; Oak Lawn, IL; Rockford, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1720501257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WEST DUNDEE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "60090",
            "telephone_number": "847-215-1525",
            "fax_number": "847-215-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W DUNDEE RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600904863",
            "telephone_number": "847-215-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY SERVICE OF AMERICA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "POTACH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-215-1525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.