NPIMap

Organization Active NPI

Caneva Foot & Ankle Clinic, LTD.

  • Podiatrist
  • Joliet, IL
National Provider Identifier
1902092554
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004255 Issued in IL
Legal business name
CANEVA FOOT & ANKLE CLINIC, LTD.
Practice address
200 N Hammes Ave
Joliet, IL 60435-6677
Phone
(815) 741-0791
Fax
(815) 741-9576
NPI assigned
Sep 18, 2007
Last updated
Feb 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Authorized official

Name
Dr. Daryl Scott Caneva, DPMNPI 1922107838
Title
Owner
Phone
(815) 741-0791

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
Podiatrist 213E00000X 016004255 IL Primary

Addresses

Primary practice location

200 N Hammes Ave
Joliet, IL 60435-6677

Mailing address

200 N Hammes Ave
Joliet, IL 60435-6677
Phone (815) 741-0791

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100607000595 IL Part B Supplier - Clinic/Group Practice 8921133018 Receives reassigned benefits from 4 practitioners
Practice locations: Joliet, IL; Lockport, IL

National Provider Directory

National Provider Directory

Locations

1000 S Hamilton St
Lockport, IL 60441
Phone (815) 838-4921

Practitioners & affiliated clinicians

Practitioners 4

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": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1902092554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356677",
            "telephone_number": "815-741-0791",
            "fax_number": "815-741-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N HAMMES AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356677",
            "telephone_number": "815-741-0791",
            "fax_number": "815-741-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANEVA FOOT & ANKLE CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "CANEVA",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-741-0791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.