Organization Active NPI

Summit Foot and Ankle Center P.C.

  • Foot & Ankle Surgery Podiatrist
  • Oak Park, IL
National Provider Identifier
1861115404
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SUMMIT FOOT AND ANKLE CENTER P.C.
Practice address
1515 N Harlem Ave Ste 100
Oak Park, IL 60302-1205
Phone
(708) 390-9517
NPI assigned
Sep 20, 2022
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Tanvi Kadakia, DPMNPI 1891289765
Title
Authorized Official
Phone
(630) 770-2197

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 Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

1515 N Harlem Ave Ste 100
Oak Park, IL 60302-1205

Mailing address

801 S Financial PL Apt 3205
Chicago, IL 60605-1790
Phone (708) 390-9517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221108000304 IL Part B Supplier - Clinic/Group Practice 2769859511 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Park, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1861115404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S FINANCIAL PL APT 3205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051790",
            "telephone_number": "708-390-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N HARLEM AVE STE 100",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021205",
            "telephone_number": "708-390-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT FOOT AND ANKLE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "KADAKIA",
        "authorized_official_first_name": "TANVI",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "630-770-2197",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.