Individual provider Active NPI

Mackenzi J. Nelson, D.P.M

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1962689380
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07001100A Issued in IN
Practice address
225 W Washington St Ste 1500
Chicago, IL 60606-3485
Phone
(847) 504-5000
Fax
(847) 504-5015
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X LL9464 MD
Podiatrist 213E00000X 99040479A IN
Podiatrist 213E00000X 07001100A IN Primary

Addresses

Primary practice location

225 W Washington St Ste 1500
Chicago, IL 60606-3485

Mailing address

225 W Washington St Ste 1500
Chicago, IL 60606-3485
Phone (847) 504-5000

Other identifiers 2

IdentifierTypeStateIssuer
P01242897OtherARRAILROAD MEDICARE
199966717MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100304000247 IN Practitioner - Podiatry 6002951886 Reassigns benefits to 1 organization
I20181220001844 TN Practitioner - Podiatry 6002951886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

1 Sisters of Providence
Saint Mary of the Woods, IN 47876-1007
Phone (812) 535-1050

202 E MTCS Rd
Murfreesboro, TN 37129-1524
Phone (615) 849-8748

5436 Edmondson Pike
Nashville, TN 37211-5835
Phone (615) 837-8006

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue5383
Removal or shaving of skin growth786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001100AINMDPodiatrist
99040479AINMDPodiatrist
LL9464MDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist CurrentSince Jan 19, 2010 Accepting new patients
Preferred Podiatry Group PC Podiatrist Past Accepting new patients

Locations

800 Brookside Dr
Little Rock, AR 72205
Phone (501) 224-3940

102 N Gutensohn Rd
Springdale, AR 72762
Phone (479) 756-0330

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

425 Huehl Rd
#13
Northbrook, IL 60062
Phone (847) 504-5007

425 Huehl Rd
Unit 13
Northbrook, IL 60062
Phone (800) 654-3772

762 N Dan Jones Rd
Avon, IN 46123
Phone (201) 856-0224

1 Sisters of Providence
St Mary of Wd, IN 47876
Phone (812) 535-1051

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1962689380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063485",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063485",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MACKENZI",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "LL9464",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "99040479A",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001100A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01242897",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199966717",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.