DR. DEAN THOMAS SERLETIC (NPI# 1487789285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487789285 |
| Entity Type | Individual |
| Full Name | DR. DEAN THOMAS SERLETIC |
| Credential | D.P.M. |
| Practice Address |
425 Huehl Rd, Unit 13 Northbrook IL 60062-2319 |
| Mailing Address |
1120 Medical Plaza Dr Suite# 180 Shenandoah TX 77380-3242 |
| Practice Telephone | 8475045000 |
| Practice Fax Number | 8475045015 |
| Mailing Telephone | 2813649041 |
| Mailing Fax Number | 2813639712 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2015-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2035 | TX | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016-003973 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD MEDICARE | 480004765 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 601-01280 | 01 |
| IL | RAILROAD MEDICARE | P01458515 | 01 |
| Street Address |
425 HUEHL RD, UNIT 13 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-2319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921483 | Joseph S. Borreggine | Podiatrist | 40 Skokie Blvd Ste 520, Northbrook, IL 60062-1601 | 2005-06-02 |
| 1942593231 | Kelley Oralivia Holloway - Marshall | Podiatrist | 40 Skokie Blvd Ste 520, Northbrook, IL 60062-1601 | 2011-05-19 |
| 1407180532 | Jennifer Bara | Podiatrist | 425 Huehl Rd Unit 13, Northbrook, IL 60062-2319 | 2009-09-22 |
| 1013117050 | Mollye Deborah Karp | Podiatrist | 425 Huehl Rd Unit 13, Northbrook, IL 60062-2319 | 2007-07-18 |
| 1124020821 | Richard Lane Kusunose | Podiatrist | 40 Skokie Blvd Ste 520, Northbrook, IL 60062-1601 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930485 | Mid America Foot & Ankle Specialist Illinois LLC | Podiatrist | 2003 Montgomery Rd Ste 108109, Aurora, IL 60504-9078 | 2020-07-22 |
| 1265040026 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 4121 Fairview Ave Ste 102, Downers Grove, IL 60515-2266 | 2020-07-17 |
| 1316563612 | Jacob Tilsley | Podiatrist | 610 S Maple Ave Ste 2250, Oak Park, IL 60304-1093 | 2020-06-22 |
| 1033738547 | C James Anderson Dpm LLC | Podiatrist | 1000 Eleven S Ste 3a, Columbia, IL 62236-1077 | 2020-04-14 |
| 1386263895 | C James Anderson Dpm LLC | Podiatrist | 717 Insight Ave Ste 100, O Fallon, IL 62269-2193 | 2020-04-14 |
| 1821631367 | Dr Christine Heck PC | Podiatrist | 111 N Wabash Ave Ste 1914, Chicago, IL 60602-2968 | 2019-10-28 |
| 1013562578 | Bishoy Atef Botros | Podiatrist | 820 S Damen Ave Fl 7, Chicago, IL 60612-3728 | 2019-08-01 |
| 1538623947 | Steven B Overpeck Dpm PC | Podiatrist | 25520 S Pheasant Ln Unit K, Channahon, IL 60410-8808 | 2019-01-30 |
| 1366916355 | Center for Foot and Ankle Surgery Ltd | Podiatrist | 654 W Veterans Pkwy Ste D, Yorkville, IL 60560-2510 | 2019-01-14 |
| 1497224950 | Northern Illinois Foot & Ankle Specialists, Ltd | Podiatrist | 1288 S Us Highway 12, Fox Lake, IL 60020-1950 | 2018-11-14 |
| Find all providers with the same taxonomy | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on DR. DEAN THOMAS SERLETIC.
| 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.