MCDERMOTT PODIATRY OF JOLIET PC NPI 1598068850

NPI Information

NPI: 1598068850
Provider Name: MCDERMOTT PODIATRY OF JOLIET PC

Doing Business As: MCDERMOTT PODIATRY OF JOLIET

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
14532 JOHN HUMPHREY DR
ORLAND PARK, IL
ZIP 60462
Phone: (708) 403-1611
Get Directions

MCDERMOTT PODIATRY OF JOLIET PC is a foot and ankle surgery podiatrist in Orland Park, IL. MCDERMOTT PODIATRY OF JOLIET PC NPI is 1598068850. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mcdermott Podiatry Of Joliet.

The provider's business location address is:

14532 JOHN HUMPHREY DR
ORLAND PARK, IL
ZIP 60462-640
Phone: (708) 403-1611
Fax: (708) 403-1650

The provider's authorized official is Michael Mcdermott .
The authorized official title is Owner and has the following contact phone number (708) 403-1611.

The enumeration date for this NPI number is 12/8/2010 and was last updated on 12/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	016004034	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	016004034	MEDICAID	ILLINOIS
2	IL4307	OTHER	ILLINOIS	MEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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