Luis E. Mendoza LTD

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

LUIS E. MENDOZA LTD

Practice address

5610 W Cermak Rd
Unit 2
Cicero, IL 60804-2219

Phone

(708) 780-8661

Fax

(708) 780-9537

NPI assigned

Oct 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Luis E Mendoza, DPMNPI 1306887328

Title

President

Phone

(708) 780-8661

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Luis E Mendoza, DPM

  • Podiatrist
  • Cicero, IL
  • NPI 1306887328
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1922287663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 W CERMAK RD",
            "address_2": "UNIT 2",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042219",
            "telephone_number": "708-780-8661",
            "fax_number": "708-780-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 W CERMAK RD",
            "address_2": "UNIT 2",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042219",
            "telephone_number": "708-780-8661",
            "fax_number": "708-780-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS E. MENDOZA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-780-8661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Cicero, IL
• Providers in Cicero, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.