Individual provider Active NPI

Julie M Stride, D.P.M.

  • Foot Surgery Podiatrist
  • Lake Forest, IL
National Provider Identifier
1972538742
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Practice address
1200 N Westmoreland Rd
Lake Forest, IL 60045-1601
Phone
(847) 234-6164
Fax
(847) 535-7840
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X IL Primary

Addresses

Primary practice location

1200 N Westmoreland Rd
Lake Forest, IL 60045-1601

Mailing address

PO Box 64
Lake Bluff, IL 60044-0064
Phone (847) 234-6164

Other identifiers 2

IdentifierTypeStateIssuer
0004905313OtherILBLUE CROSS BLUE SHIELD
5020028OtherAETNA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
016004546ILMDFoot Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972538742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600440064",
            "telephone_number": "847-234-6164",
            "fax_number": "847-535-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451601",
            "telephone_number": "847-234-6164",
            "fax_number": "847-535-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRIDE",
        "first_name": "JULIE",
        "middle_name": "M",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0004905313",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5020028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.