Rudolph J. Petrich, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016003067 Issued in IL

Practice address

14 S Addison St
Bensenville, IL 60106-2126

Phone

(630) 766-8720

Fax

(630) 766-9228

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dupage Foot & Ankle Associates

  • Podiatrist
  • Bensenville, IL
  • NPI 1124206834
  NPD Authorized official
• Circle Family Healthcare Network, Inc

  • Community Health Clinic/Center
  • Chicago, IL
  • NPI 1649399106
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1851313019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S ADDISON ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062126",
            "telephone_number": "630-766-8720",
            "fax_number": "630-766-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S ADDISON ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062126",
            "telephone_number": "630-766-8720",
            "fax_number": "630-766-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICH",
        "first_name": "RUDOLPH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016003067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003067",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shivam S Patel, D.D.S
• Sarah Paul
• Pena Clinic PLLC
• Alvaro Enrique Pena, M.D.
• Lisa Nicole Pena, APN
• Pharmerica Drug Systems LLC
• Joli Phillips, M.S. CCC-SLP
• Physiotherapy Associates Inc
• Alma Pienkowski, D.D.S
• Raymond Vincent Pineda

• Podiatrist in Bensenville, IL
• Providers in Bensenville, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.