Freedom Foot Clinics of Illinois SC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016004482 Issued in IL

Legal business name

FREEDOM FOOT CLINICS OF ILLINOIS SC

Practice address

3245 Grove Ave
Suite #103
Berwyn, IL 60402-3474

Phone

(708) 484-3599

Fax

(708) 749-0727

NPI assigned

Oct 5, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Cynthia Mercado I, DPM

Title

Podiatrist

Phone

(708) 484-3599

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1902180201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE",
            "address_2": "SUITE #103",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023474",
            "telephone_number": "708-484-3599",
            "fax_number": "708-749-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE",
            "address_2": "SUITE #103",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023474",
            "telephone_number": "708-484-3599",
            "fax_number": "708-749-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM FOOT CLINICS OF ILLINOIS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "708-484-3599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004482",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Elaine Flores, LCPC
• Edward Foley, MD
• Forefront Dermatology, S.C.
• Daniel Vincent Fortuna, D.C.
• Barbara Foster
• Christine Freeman, LCSW
• Shayna Friedman
• Clair Fron
• Adriana Fuentes
• G.a.Pharmacy

• Foot & Ankle Surgery Podiatrist in Berwyn, IL
• Providers in Berwyn, 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 Oct 5, 2011; 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.