Individual provider Active NPI

David F Hettinger, DPM

  • Podiatrist
  • Wheaton, IL
National Provider Identifier
1821099276
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016003842 Issued in IL
Practice address
59 Danada SQ E
Wheaton, IL 60189-8484
Phone
(630) 682-3338
Fax
(630) 682-5836
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016003842 IL Primary

Addresses

Primary practice location

59 Danada SQ E
Wheaton, IL 60189-8484

Mailing address

2030 Appaloosa CT W
Wheaton, IL 60189-8922
Phone (630) 682-3338

Other identifiers 1

IdentifierTypeStateIssuer
363842498OtherILCORPORATE TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000928 IL Practitioner - Podiatry 8628006624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1275 Butterfield Rd
Suite 110
Wheaton, IL 60189-8849
Phone (630) 682-3338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue147
Removal or shaving of skin growth107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016003842ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hettinger Podiatry Center, PC Podiatrist Current Accepting new patients
Hettinger Podiatry Center, PC Podiatrist CurrentSince Aug 1, 2005 Accepting new patients

Locations

1275 Butterfield Rd
Ste 110
Wheaton, IL 60189
Phone (630) 510-0080

59 Danada Sq E
Wheaton, IL 60189
Phone (630) 682-3338

Organizations & group practices 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1821099276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 APPALOOSA CT W",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898922",
            "telephone_number": "630-682-3338",
            "fax_number": "630-682-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 DANADA SQ E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898484",
            "telephone_number": "630-682-3338",
            "fax_number": "630-682-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTINGER",
        "first_name": "DAVID",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE TAX ID",
            "identifier": "363842498",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.