NPIMap

Organization Active NPI

M McNeill DPM Incorporated

Doing business as Prairie Path Foot and Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Elmhurst, IL
National Provider Identifier
1831393727
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-005059 Issued in IL
Legal business name
M MCNEILL DPM INCORPORATED
Doing business as
Prairie Path Foot and Ankle Clinic
Practice address
136 W Vallette St
Suite #2
Elmhurst, IL 60126-4377
Phone
(630) 834-3668
Fax
(630) 834-4015
NPI assigned
Jun 13, 2007
Last updated
Aug 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Misty McNeill, DPMNPI 1922085505
Title
DPM
Phone
(630) 834-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016-005059 IL Primary

Addresses

Primary practice location

136 W Vallette St
Suite #2
Elmhurst, IL 60126-4377

Mailing address

136 W Vallette St
Suite #2
Elmhurst, IL 60126-4377
Phone (630) 834-3668

Other practice location 1

965 Lake St
Oak Park, IL 60301-1292
Phone (630) 834-3668

Other names 1

  • Prairie Path Foot and Ankle Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

532 S York St
Elmhurst, IL 60126
Phone (630) 834-3668

11 E Schaumburg Rd
Schaumburg, IL 60194
Phone (847) 985-8380

411 W Saint Charles Rd
Villa Park, IL 60181
Phone (630) 691-1234

Practitioners & affiliated clinicians

Practitioners 4

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": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1831393727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W VALLETTE ST",
            "address_2": "SUITE #2",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264377",
            "telephone_number": "630-834-3668",
            "fax_number": "630-834-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W VALLETTE ST",
            "address_2": "SUITE #2",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264377",
            "telephone_number": "630-834-3668",
            "fax_number": "630-834-4015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 Lake St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011292",
            "country_code": "US",
            "telephone_number": "630-834-3668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "M MCNEILL DPM INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "MCNEILL",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "630-834-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-005059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Path Foot and Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prairie Path Foot and Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.