Willowbrook Podiatry Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

License

004656 Issued in IL

Legal business name

WILLOWBROOK PODIATRY INC

Practice address

62 63Rd St
Willow Brook, IL 60527-2982

Phone

(630) 887-9221

NPI assigned

May 3, 2006

Last updated

Jun 15, 2010By 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

Timothy Lantvit, DPMNPI 1720134422

Title

Owner

Phone

(630) 887-9221

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

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.

• Timothy T Lantvit, DPM

  • Podiatrist
  • Northbrook, IL
  • NPI 1720134422
  Medicare reassignment NPD Authorized official
• Michelle Renee Murray-Clark, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Chicago, IL
  • NPI 1295780153
  NPD (past)
• Athanasia Sarros, DPM.

  • Podiatrist
  • Chicago, IL
  • NPI 1689626905
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1932167228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 63RD ST",
            "city": "WILLOW BROOK",
            "state": "IL",
            "postal_code": "605272982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 63RD ST",
            "city": "WILLOW BROOK",
            "state": "IL",
            "postal_code": "605272982",
            "telephone_number": "630-887-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBROOK PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "LANTVIT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-887-9221",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "004656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200136470A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC # WITH PPG",
            "identifier": "0732240001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0002219563",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004656",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DG8105",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Willowbrook Behavior Health LLC
• Willowbrook Clinics and Medical Center S.C.
• Willowbrook Dentistry for Children, LLC
• Willowbrook Family Practice LTD
• Willowbrook Medical Center LTD.
• Jennifer A Wilson, PT
• Laura A Wilson, FNP-C
• Jake L. Wines, D.C.
• Scott M Wirth, DPT
• Wisdom Care & Consulting Services, Inc (WCCS Inc)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.