PODIATRY CENTER, SC (NPI# 1265607816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265607816 |
| Entity Type | Organization |
| Organization Name | PODIATRY CENTER, SC |
| Practice Address |
424 75th St Downers Grove IL 60516-4454 |
| Practice Telephone | 6305150705 |
| Practice Fax Number | 6305150783 |
| Mailing Telephone | 6305150705 |
| Mailing Fax Number | 6305150783 |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |
| Authorized Official Name | DR. JOHN M. WRAY (PRESIDENT) |
| Authorized Official Telephone | 6305150705 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PROVIDER NUMBER | 598830 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548381825 | Podiatry Center, Sc | Clinic/Center | 30 N Michigan Ave, Suite 1129, Chicago, IL 60602-3402 | 2007-04-03 |
| Street Address |
424 75TH ST |
| City | DOWNERS GROVE |
| State | IL |
| Zip Code | 60516-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548240807 | William J. Miller | Podiatrist | 424 75th St, Downers Grove, IL 60516-4454 | 2006-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174015432 | Costula Cassiani | Behavior Technician | 20w438 Camder Drive, Downers Grove, IL 60516 | 2018-06-02 |
| 1346769130 | Zahra Bohri | Dietitian, Registered | 6337 Blodgett Ct, Downers Grove, IL 60516 | 2017-09-13 |
| 1033567359 | Samuel Brooks Allen | Dentist | 6800 Main St., Third Floor, Downers Grove, IL 60516 | 2016-05-26 |
| 1396019469 | Beverly Woltman | Technician/Technologist | 6800 S. Main Street, Suite Ll5, Downers Grove, IL 60516 | 2012-03-06 |
| 1992080642 | Verna Dianne Velazquez | Counselor | 5630 Hillcrest Rd, Downers Grove, IL 60516 | 2011-10-13 |
| 1598048274 | Rabia Ansari | Optometrist | 1530 W 75th St, Downers Grove, IL 60516 | 2011-09-20 |
| 1487971545 | Brilliant Dental LLC | Dentist | 1400 W 75th St, B1, Downers Grove, IL 60516 | 2010-04-29 |
| 1235466558 | Erika D Schultz | Social Worker | 11008 Palmer St., Downers Grove, IL 60516 | 2009-11-06 |
| 1124253836 | Main Street Chiropractic and Wellness Center Ltd | Clinic/Center | 6234 S Main Street, Downers Grove, IL 60516 | 2009-05-26 |
| 1841439320 | Lisa Marie Burknap | Behavioral Analyst | 9 South 329 Cumnor, Downers Grove, IL 60516 | 2009-02-06 |
| Find all providers in zip 60516 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609382902 | Geneva Family Dentistry, P.C. | Clinic/Center | 2932 Finley Rd, Downers Grove, IL 60515-1042 | 2017-12-21 |
| 1952739070 | Nicole Brod, D.c. LLC | Clinic/Center | 1121 Warren Ave, Suite 270, Downers Grove, IL 60515-3570 | 2013-10-29 |
| 1538445317 | Midwestern University | Clinic/Center | 3450 Lacey Rd, Downers Grove, IL 60515-5430 | 2011-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
| City | DOWNERS GROVE |
| Zip Code | 60516 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.