NPIMap

Organization Active NPI

Mark E Neamand DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Park Ridge, IL
National Provider Identifier
1831370477
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
MARK E NEAMAND DPM PC
Practice address
621 Devon Ave
Park Ridge, IL 60068-4732
Phone
(847) 698-2895
Fax
(847) 698-2942
NPI assigned
Nov 26, 2007
Last updated
Nov 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Authorized official

Name
Mark E Neamand, DPM PCNPI 1194884452
Title
President
Phone
(847) 698-2895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

621 Devon Ave
Park Ridge, IL 60068-4732

Mailing address

621 Devon Ave
Park Ridge, IL 60068-4732
Phone (847) 698-2895

Other identifiers 2

IdentifierTypeStateIssuer
DC4413OtherILRAILROAD MEDICARE GROUP NUMBER
001626856OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080430000096 IL Part B Supplier - Clinic/Group Practice 2365521515 Receives reassigned benefits from 6 practitioners
Practice locations: Chicago, IL; Elk Grove Village, IL; Morton Grove, IL; Park Ridge, IL
O20100930094333 IL DME Supplier - Physician - Podiatry 2365521515 Practice locations: Park Ridge, IL

National Provider Directory

National Provider Directory

Locations

6140 Dempster St
Morton Grove, IL 60053
Phone (847) 698-2895

621 Devon Ave
Park Ridge, IL 60068
Phone (847) 698-2895

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1831370477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684732",
            "telephone_number": "847-698-2895",
            "fax_number": "847-698-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684732",
            "telephone_number": "847-698-2895",
            "fax_number": "847-698-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E NEAMAND DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "NEAMAND",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-698-2895",
        "authorized_official_credential": "DPM PC"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP NUMBER",
            "identifier": "DC4413",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001626856",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.