Podiatry & Sports Medicine Associates P.C.

Organization Active NPI Podiatrist · Park City, IL

NPI 1831385574 · NPPES record last updated Mar 17, 2025

Key facts

NPI
1831385574
Entity type
Organization (NPI type 2)
Primary specialty
Podiatrist 213E00000X
License
016004452 (IL)
Legal business name
PODIATRY & SPORTS MEDICINE ASSOCIATES P.C.
Practice address
351 S Greenleaf St
Suite C
Park City, IL 60085-5725
Phone
(847) 263-6073
Fax
(847) 244-7323
NPI assigned
Sep 17, 2007
Organization subpart
No

Authorized official

Name
Lisa M Schoene NPI 1891788139
Title
Direct Owner
Phone
(847) 263-6073

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

Practitioners 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041110000028 IL Part B Supplier - Clinic/Group Practice 2264495365 Receives reassigned benefits from 4 practitioners
Practice locations: Park City, IL
O20101014001437 IL DME Supplier - Physician - Podiatry 2264495365 Practice locations: Park City, IL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213E00000X 016004452 IL Yes

Addresses

Primary practice location

351 S Greenleaf St
Suite C
Park City, IL 60085-5725

Mailing address

351 S Greenleaf St
Suite C
Park City, IL 60085-5725
Phone (847) 263-6073

Other names

  • LISA M. SCHOENE DPM PC Doing business as

Other providers in Park City, IL

All providers in Park City, IL · Podiatrist in Illinois

Sources for this page

Verify at the official NPI Registry.