NPIMap

Organization Active NPI

Performance Foot and Ankle Center LLC

  • Podiatrist
  • South Holland, IL
National Provider Identifier
1750397428
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PERFORMANCE FOOT AND ANKLE CENTER LLC
Practice address
401 E 162ND St
Suite 101
South Holland, IL 60473-2236
Phone
(708) 596-3757
Fax
(708) 596-3779
NPI assigned
Aug 1, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Dale Steven Brink, DPM, FACFASNPI 1093722365
Title
Doctor
Phone
(708) 596-3757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X IL Primary
Durable Medical Equipment & Medical Supplies 332B00000X 5000520001 IL

Addresses

Primary practice location

401 E 162ND St
Suite 101
South Holland, IL 60473-2236

Mailing address

401 E 162ND St
Suite 101
South Holland, IL 60473-2236
Phone (708) 596-3757

National Provider Directory

National Provider Directory

Locations

401 E 162nd St
South Holland, IL 60473
Phone (773) 819-5504

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750397428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 162ND ST",
            "address_2": "SUITE 101",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732236",
            "telephone_number": "708-596-3757",
            "fax_number": "708-596-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 162ND ST",
            "address_2": "SUITE 101",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732236",
            "telephone_number": "708-596-3757",
            "fax_number": "708-596-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "708-596-3757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM, FACFAS"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "5000520001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.