Prairie Foot & Ankle, P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016.005367 Issued in IL

Legal business name

PRAIRIE FOOT & ANKLE, P.C.

Practice address

2371 Bowes Road
Suite 400
Elgin, IL 60123

Phone

(630) 715-8291

NPI assigned

Mar 20, 2013

Last updated

Jun 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Denise Mary-Danielle Lee, MM/HRM

Title

Practice Administrator

Phone

(224) 227-6973

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Tax ID family

Prairie Foot Ankle PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Prairie Foot & Ankle, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1346752656
  NPD tax ID

Locations

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.

• Supreet Kaur Dhaliwal

  • Foot & Ankle Surgery Podiatrist
  • Elgin, IL
  • NPI 1912168931
  Medicare reassignment NPD

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1881936649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2371 BOWES ROAD",
            "address_2": "STE 400",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "630-715-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2371 BOWES ROAD",
            "address_2": "SUITE 400",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "630-715-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE FOOT & ANKLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "MARY-DANIELLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "224-227-6973",
        "authorized_official_credential": "MM/HRM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothea Poulos, MD
• Amanda Jean Powell, RN, APN, FNP-C
• Keyana Powell
• Eva B Powers, MS
• Lauren Powers
• Betty Lois Pratt, FNP-BC
• Pamela Frances Predmore, L.C.P.C.
• Preferred Open MRI LTD (Preferred Imaging)
• Premier Womens Health Associates SC
• Premise Health of Illinois Medical PC (MCL Health Center)

• Foot & Ankle Surgery Podiatrist in Elgin, IL
• Providers in Elgin, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.