Active NPI
Joel Aaron Feder, D.P.M.
- Podiatrist
- Chicago, IL
National Provider Identifier
1952394405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016-002519
- Practice address
- 4211 N Cicero Ave
Suite 301
Chicago, IL 60641-1651 - Phone
- (773) 202-8800
- Fax
- (773) 202-8810
- NPI assigned
- Aug 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 016-002519 | IL | Primary |
Addresses
Primary practice location
4211 N Cicero Ave
Suite 301
Chicago, IL 60641-1651
Mailing address
4211 N Cicero Ave
Suite 301
Chicago, IL 60641-1651
Phone (773) 202-8800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016-002519 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-002519 | IL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Rehab PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Roselle, IL
- NPI 1629249917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1952394405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4211 N CICERO AVE",
"address_2": "SUITE 301",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606411651",
"telephone_number": "773-202-8800",
"fax_number": "773-202-8810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 N CICERO AVE",
"address_2": "SUITE 301",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606411651",
"telephone_number": "773-202-8800",
"fax_number": "773-202-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDER",
"first_name": "JOEL",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IL",
"license": "016-002519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016-002519",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.