South Shore Foot and Ankle Wellness Center LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

SOUTH SHORE FOOT AND ANKLE WELLNESS CENTER LLC

Practice address

2223 E 79TH St
Chicago, IL 60649-5016

Phone

(773) 978-2100

NPI assigned

Apr 18, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Peter Akerele, DPMNPI 1609874015

Title

Owner

Phone

(773) 978-2100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Peter B Akerele, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1609874015
  Medicare reassignment NPD Authorized official
• Onwukamike Patrick Nwankpa, DPM

  • Podiatrist
  • Evanston, IL
  • NPI 1801143482
  NPD (past)

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1831886209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 E 79TH STREET, CHICAGO , IL. 60649",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60649",
            "telephone_number": "773-978-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 E 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606495016",
            "telephone_number": "773-978-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE FOOT AND ANKLE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "AKERELE",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-978-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Loop Skilled Nursing Facility LLC
• South Loop Urgent Care, LLC
• South Michigan Ave Investments LLC
• South Pulaski Surgical, LTD
• South Shore Cardiology Group Inc
• South Shore Hospital Corporation
• South Shore Hospital Corporation
• South Shore Hospital Corporation
• South Shore Hospital Corporation
• South Shore Lake Front Services, Inc

• Podiatric Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Podiatric Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.