Frederick R Spencer, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

016-003528 Issued in IL

Practice address

608 Hillgrove Ave
Western Springs, IL 60558-1476

Phone

(708) 246-4591

Fax

(708) 246-2086

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223856000000",
    "number": "1750430104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 CALCUTTA LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632215",
            "telephone_number": "708-246-4591",
            "fax_number": "708-246-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581476",
            "telephone_number": "708-246-4591",
            "fax_number": "708-246-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "FREDERICK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016-003528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003528",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Stauber, MA
• Vicky Steen, LMT, CMMP

• Primary Podiatric Medicine Podiatrist in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Primary Podiatric Medicine Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.