DR. MARK SPACCAPANICCIA (NPI# 1003994112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003994112 |
| Entity Type | Individual |
| Full Name | DR. MARK SPACCAPANICCIA |
| Credential | D.P.M. |
| Practice Address |
2340 S Highland Ave Lombard IL 60148-5371 |
| Practice Telephone | 6304953338 |
| Practice Fax Number | 6304953350 |
| Mailing Telephone | 6304953338 |
| Mailing Fax Number | 6304953350 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2008-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0060015180 | 01 |
| IL | BCBS | 0060015182 | 01 |
| Street Address |
2340 S HIGHLAND AVE |
| City | LOMBARD |
| State | IL |
| Zip Code | 60148-5371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417939323 | Gregory C Castello | Family Medicine | 2340 S Highland Ave, Suite 370, Lombard, IL 60148-5371 | 2005-11-16 |
| 1407391212 | Davena Janeen Beal | Nurse Practitioner | 2340 S Highland Ave, Suite 300, Lombard, IL 60148-5371 | 2017-01-03 |
| 1992247084 | Othman Orthodontics Inc | Dentist | 2340 S Highland Ave, Ste 310, Lombard, IL 60148-5371 | 2016-11-07 |
| 1811356215 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 2340 S Highland Ave, Lombard, IL 60148-5371 | 2016-02-15 |
| 1265858013 | Marian Glenn | Nurse Practitioner | 2340 S Highland Ave, Suite 300, Lombard, IL 60148-5371 | 2014-03-17 |
| 1033542535 | Adventist Health Partners, Inc | Family Medicine | 2340 S Highland Ave, Suite 370, Lombard, IL 60148-5371 | 2013-08-20 |
| 1063852895 | Amazehealth Weight Loss & Wellness, Sc | Family Medicine | 2340 S Highland Ave, Suite 370, Lombard, IL 60148-5371 | 2013-06-25 |
| 1629415757 | Dr. Nicole Kott Ltd | Dentist | 2340 S Highland Ave, Suite 320, Lombard, IL 60148-5371 | 2013-05-30 |
| 1811266026 | Erin Valentino | Physician Assistant | 2340 S Highland Ave, Ste 370, Lombard, IL 60148-5371 | 2011-12-16 |
| 1649567231 | Fazal Ahmed Md PC | Psychologist | 2340 S Highland Ave, Suite 370, Lombard, IL 60148-5371 | 2011-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778919 | Alish Kuply | Pharmacist | 2050 S Finley Rd Suite 20, Lombard, IL 60148 | 2020-04-06 |
| 1114567880 | Danielle Slansky | Speech-Language Pathologist | 401 N. Main St, Lombard, IL 60148 | 2020-01-10 |
| 1245715572 | Ellen Mary Corey | Behavior Technician | 627 S Grace St., Lombard, IL 60148 | 2018-10-02 |
| 1194204461 | Vip 2u, Inc | Internal Medicine | 477 E Butterfield Rd Ste 400, Lombard, IL 60148 | 2018-08-08 |
| 1881185684 | Samantha Lanagan | Behavior Technician | 21 W 356 Sidney Ave, Lombard, IL 60148 | 2018-05-29 |
| 1629570114 | Iris Victoria Goss | Hearing Instrument Specialist | 412 E. Roosevelt Rd, Lombard, IL 60148 | 2018-03-01 |
| 1780102350 | Richard Wong | Dentist | 845 S. Main St #300, Lombard, IL 60148 | 2017-09-05 |
| 1033637038 | Lora Lea Biesenkamp | Counselor | 450 E 22nd St Ste 150-17, Lombard, IL 60148 | 2017-08-30 |
| 1609392836 | Shafiq Ur Rehman | Specialist/Technologist, Other | 2005 South Finley Rd Unit 1012, Lombard, IL 60148 | 2017-08-18 |
| 1033642715 | Great Lakes Living Solutions Corp. | Home Health | 477 E. Butterfield Rd., Suite Ll005, Lombard, IL 60148 | 2017-04-09 |
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| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508844275 | Esther H Lyon | Podiatrist | 6 E Saint Charles Rd, Suite 100, Lombard, IL 60148-2302 | 2006-01-04 |
| 1073507331 | Scott Allen Zimmerman | Podiatrist | 10 E 22nd St, Suite 205, Lombard, IL 60148-4977 | 2005-09-01 |
| 1538163456 | William M Noorlag | Podiatrist | 130 S. Main Street, Suite 202, Lombard, IL 60148 | 2005-06-09 |
| 1467709410 | Lyon Foot & Ankle Clinic, P.C. | Podiatrist | 6 E Saint Charles Rd, Lombard, IL 60148-2302 | 2012-08-09 |
| 1285837096 | Scott A Zimmerman, D.p.m., Ltd. | Podiatrist | 10 E 22nd St, Suite 205, Lombard, IL 60148-6108 | 2007-06-08 |
| 1215067806 | Spaccapaniccia Podiatry Ltd PC | Podiatrist | 2340 S Highland Ave, Lombard, IL 60148-5371 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200343 | Podiatric Management Systems LLC | Podiatrist | 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 | 2020-09-21 |
| 1114533700 | Podiatric Management Systems LLC | Podiatrist | 537 W 31st St, Chicago, IL 60616-3294 | 2020-09-18 |
| 1306452099 | Podiatric Management Systems LLC | Podiatrist | 2 W Talcott Rd Ste 23, Park Ridge, IL 60068-5558 | 2020-09-18 |
| 1073129763 | Podiatric Management Systems LLC | Podiatrist | 4310f W Crystal Lake Rd # F, Mchenry, IL 60050-4208 | 2020-09-18 |
| 1679187090 | Podiatric Management Systems LLC | Podiatrist | 5600 W Addison St Lowr 2ll, Chicago, IL 60634-4499 | 2020-09-02 |
| 1932742848 | Foot and Ankle Care & Associates, Ltd | Podiatrist | 3320 W 63rd St, Chicago, IL 60629-3317 | 2019-10-23 |
| 1437622966 | Tomasz Szmyd Dpm, PC | Podiatrist | 1500 E 67th St, Chicago, IL 60637-4427 | 2019-01-08 |
| 1689145898 | S Thomas Sehy D P M L L C | Podiatrist | 213 Nw 10th St Ste B, Fairfield, IL 62837-1219 | 2018-12-16 |
| 1548746761 | Jeremy Marchand | Podiatrist | 2751 W Winona St Rm Ap457, Chicago, IL 60625-2508 | 2018-07-11 |
| 1932693744 | Giovanni Incandela | Podiatrist | 700 E Algonquin Rd Unit 2313, Schaumburg, IL 60173-3835 | 2018-06-15 |
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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.