Illinois Foot and Ankle Specialists, P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016005453 Issued in IL

Legal business name

ILLINOIS FOOT AND ANKLE SPECIALISTS, P.C.

Practice address

5485 N Milwaukee Ave
Chicago, IL 60630-1249

Phone

(773) 763-6655

Fax

(773) 763-5117

NPI assigned

Feb 7, 2013

Organization subpart

No

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

Authorized official

Name

Katarzyna Nietupski, D.P.M.NPI 1912299926

Title

Owner

Phone

(630) 699-5089

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katarzyna Nietupski, D.P.M

  • Podiatrist
  • Chicago, IL
  • NPI 1912299926
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1760721963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 N PLAMONDON DR",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011933",
            "telephone_number": "630-699-5089",
            "fax_number": "914-459-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5485 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301249",
            "telephone_number": "773-763-6655",
            "fax_number": "773-763-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS FOOT AND ANKLE SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "NIETUPSKI",
        "authorized_official_first_name": "KATARZYNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-699-5089",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "347886727-60630-30",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "520330001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Illinois Department of Human Services
• Illinois Department of Human Services
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• Illinois Health Practice Alliance, LLC
• Illinois Health Professionals LLC
• Illinois Health Professionals LLC

• Foot & Ankle Surgery Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.