Organization Active NPI

Suburban Foot and Ankle Specialists P.C.

  • Foot Surgery Podiatrist
  • Aurora, IL
National Provider Identifier
1811183502
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
SUBURBAN FOOT AND ANKLE SPECIALISTS P.C.
Practice address
475 N Farnsworth Ave
Aurora, IL 60505-3004
Phone
(630) 898-0022
NPI assigned
Sep 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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

Authorized official

Name
Lewis Wasserman
Title
President
Phone
(847) 219-0539

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X IL Primary

Addresses

Primary practice location

475 N Farnsworth Ave
Aurora, IL 60505-3004

Mailing address

PO Box 444
Lake Forest, IL 60045-0444

Other identifiers 1

IdentifierTypeStateIssuer
0004523326OtherILBCBS OF ILLINOIS

National Provider Directory

National Provider Directory

Locations

475 N Farnsworth Ave
Aurora, IL 60505
Phone (630) 820-3360

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189987200000",
    "number": "1811183502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 444",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N FARNSWORTH AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053004",
            "telephone_number": "630-898-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN FOOT AND ANKLE SPECIALISTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-219-0539"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "0004523326",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; 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.