Individual provider Active NPI

Angeles M Valdes, DPM

  • Foot Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1730185786
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
016003592 Issued in IL
Practice address
3632 N Western Ave
Chicago, IL 60618-4715
Phone
(773) 248-4111
Fax
(773) 248-4111
NPI assigned
Jun 23, 2005
Reactivated
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 016003592 IL Primary

Addresses

Primary practice location

3632 N Western Ave
Chicago, IL 60618-4715

Mailing address

3632 N Western Ave
Chicago, IL 60618-4715
Phone (773) 248-4111

Other identifiers 1

IdentifierTypeStateIssuer
016003592MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016003592ILMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Angeles Valdes Podiatry Center PC PastSince Jul 15, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1730185786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184715",
            "telephone_number": "773-248-4111",
            "fax_number": "773-248-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184715",
            "telephone_number": "773-248-4111",
            "fax_number": "773-248-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "ANGELES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": "016003592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003592",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.