NPIMap

Organization Active NPI

Northern Illinois Foot & Ankle Specialists, LTD

  • Foot & Ankle Surgery Podiatrist
  • Crystal Lake, IL
National Provider Identifier
1851702302
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016005350 Issued in IL
Legal business name
NORTHERN ILLINOIS FOOT & ANKLE SPECIALISTS, LTD
Practice address
750 E Terra Cotta Ave Ste a
Crystal Lake, IL 60014-3621
Phone
(847) 639-5800
NPI assigned
May 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Dr. Patrick McEneaney, D.P.M.NPI 1174613319
Title
President
Phone
(847) 639-5800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016005350 IL Primary

Addresses

Primary practice location

750 E Terra Cotta Ave Ste a
Crystal Lake, IL 60014-3621

Mailing address

750 E Terra Cotta Ave Ste C
Crystal Lake, IL 60014-3621
Phone (847) 639-5800

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140710000662 IL Part B Supplier - Clinic/Group Practice 1355566183 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
Practice locations: Fox Lake, IL; Geneva, IL; Elgin, IL; Hinsdale, IL; Hoffman Estates, IL; Lake in the Hills, IL; Cary, IL; Crystal Lake, IL…
O20140812000668 IL DME Supplier - Physician - Podiatry 1355566183 Practice locations: Crystal Lake, IL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

165 N Lakewood Rd
Lake in the Hills, IL 60156

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1400284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1851702302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "847-639-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "847-639-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS FOOT & ANKLE SPECIALISTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-17",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "MCENEANEY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-639-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.