Individual provider Active NPI

Dale M Smith, D.P.M.

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1831197052
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016002624 Issued in IL
Practice address
1030 N State St Apt 49B
Chicago, IL 60610-2839
Phone
(312) 810-7476
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Podiatrist 213E00000X 016002624 IL Primary

Addresses

Primary practice location

1030 N State St Apt 49B
Chicago, IL 60610-2839

Mailing address

5405 W 95TH St
Oak Lawn, IL 60453-2349
Phone (708) 425-7476

Other identifiers 1

IdentifierTypeStateIssuer
016002624MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016002624ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle N Foot Centers LLC Podiatrist Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25065/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1831197052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532349",
            "telephone_number": "708-425-7476",
            "fax_number": "708-425-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N STATE ST APT 49B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102839",
            "telephone_number": "312-810-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DALE",
        "middle_name": "M",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016002624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016002624",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.