Individual provider Active NPI

Guy W Mattana, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Des Plaines, IL
National Provider Identifier
1871599480
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016003633 Issued in IL
Practice address
150 N River Rd
Ste 220
Des Plaines, IL 60016-1272
Phone
(847) 487-2827
Fax
(847) 487-2860
NPI assigned
Jun 28, 2005
Last updated
May 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016003633 IL Primary

Addresses

Primary practice location

150 N River Rd
Ste 220
Des Plaines, IL 60016-1272

Mailing address

150 N River Rd
Suite 220
Des Plaines, IL 60016-1272
Phone (847) 487-2827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016003633ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fahey Medical Center S.C. Current Accepting new patients
American Home Visiting Physicians Past Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

150 N River Rd
Ste 220
Des Plaines, IL 60016
Phone (847) 391-9944

581 E Golf Rd
Des Plaines, IL 60016
Phone (847) 297-2240

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1871599480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD",
            "address_2": "SUITE 220",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272",
            "telephone_number": "847-487-2827",
            "fax_number": "847-487-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD",
            "address_2": "STE 220",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272",
            "telephone_number": "847-487-2827",
            "fax_number": "847-487-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTANA",
        "first_name": "GUY",
        "middle_name": "W",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016003633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.