Individual provider Active NPI

Cheryl R Brown-Cook, DPM

  • Foot & Ankle Surgery Podiatrist
  • Crystal Lake, IL
National Provider Identifier
1902873904
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-004864 Issued in IL
Practice address
1520 Carlemont Dr Ste M
Crystal Lake, IL 60014-1836
Phone
(815) 356-5060
Fax
(815) 356-7898
NPI assigned
Mar 8, 2006
Last updated
Apr 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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 016-004864 IL Primary

Addresses

Primary practice location

1520 Carlemont Dr Ste M
Crystal Lake, IL 60014-1836

Mailing address

1520 Carlemont Dr Ste M
Crystal Lake, IL 60014-1836
Phone (815) 356-5060

Other identifiers 2

IdentifierTypeStateIssuer
480026032OtherILRAIL ROAD MEDICARE
1625610OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040218000052 IL Practitioner - Podiatry 4385539451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1520 Carlemont Dr
Suite M
Crystal Lake, IL 60014-1836

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11
Removal of skin lesions1-10
Removal of nail tissue585
Skin biopsy14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-004864ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cheryl R Brown, PC CurrentSince Jul 1, 1998 Accepting new patients
Camilleri Medical Center LTD Foot & Ankle Surgery PastSince Jan 1, 1999 Accepting new patients
Quality Podiatry Group, LTD Foot & Ankle Surgery Past Accepting new patients
Gregory B Cook PC PastSince Dec 1, 2006 Accepting new patients

Locations

1520 Carlemont Dr
Ste M
Crystal Lake, IL 60014
Phone (815) 356-5060

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1902873904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CARLEMONT DR STE M",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141836",
            "telephone_number": "815-356-5060",
            "fax_number": "815-356-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 CARLEMONT DR STE M",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141836",
            "telephone_number": "815-356-5060",
            "fax_number": "815-356-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN-COOK",
        "first_name": "CHERYL",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-004864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "480026032",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1625610",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.