NPIMap

Organization Active NPI

Illinois Institute of Foot and Ankle, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Rolling Meadows, IL
National Provider Identifier
1831497668
Registry record updated Jul 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016005437 Issued in IL
Legal business name
ILLINOIS INSTITUTE OF FOOT AND ANKLE, P.C.
Practice address
4215 Kirchoff Rd
Rolling Meadows, IL 60008-2005
Phone
(847) 231-2517
Fax
(847) 789-7202
NPI assigned
Mar 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2020

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

Authorized official

Name
Sujin KimNPI 1770887408
Title
President
Phone
(847) 231-2517

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X
Radiology PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ER0200X
Sports Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0000X
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 016005437 IL Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 016005438 IL
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

4215 Kirchoff Rd
Rolling Meadows, IL 60008-2005

Mailing address

4215 Kirchoff Rd
Rolling Meadows, IL 60008-2005
Phone (847) 231-2517

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110721000853 IL Part B Supplier - Clinic/Group Practice 7416125224 Receives reassigned benefits from 3 practitioners
Practice locations: Rolling Meadows, IL
O20120228000156 IL DME Supplier - Physician - Podiatry 7416125224 Practice locations: Rolling Meadows, IL

National Provider Directory

National Provider Directory

Locations

855 E Palatine Rd
Ste 290
Palatine, IL 60074
Phone (847) 794-8778

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594425600000",
    "number": "1831497668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 KIRCHOFF RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600082005",
            "telephone_number": "847-231-2517",
            "fax_number": "847-789-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 KIRCHOFF RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600082005",
            "telephone_number": "847-231-2517",
            "fax_number": "847-789-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS INSTITUTE OF FOOT AND ANKLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2020-07-11",
        "certification_date": "2020-07-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUJIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-231-2517"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005437",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005438",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2020; 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.