NORTHSIDE FOOT & ANKLE PC NPI 1639507163

NPI Information

NPI: 1639507163
Provider Name: NORTHSIDE FOOT & ANKLE PC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
750 N FRANKLIN ST
SUITE 102
CHICAGO, IL
ZIP 60654
Phone: (312) 280-7886
Get Directions

NORTHSIDE FOOT & ANKLE PC is a foot and ankle surgery podiatrist in Chicago, IL. NORTHSIDE FOOT & ANKLE PC NPI is 1639507163. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

750 N FRANKLIN ST
SUITE 102
CHICAGO, IL
ZIP 60654-263
Phone: (312) 280-7886
Fax: (312) 280-9547

The provider's authorized official is Timothy S Kruse .
The authorized official title is Owner and has the following contact phone number (312) 280-7886.

The enumeration date for this NPI number is 10/18/2013 and was last updated on 5/1/2023.

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	Primary
1	213EP0504X	Podiatrist	Public Medicine	No
2	213EP1101X	Podiatrist	Primary Podiatric Medicine	No
3	213ES0131X	Podiatrist	Foot Surgery	No
4	332B00000X	Durable Medical Equipment & Medical Supplies		No
5	213ES0103X	Podiatrist	Foot & Ankle Surgery	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	016005211	MEDICAID	ILLINOIS

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: 4/28/2024

NPI Synchronization or Removal

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