FOOTCO ORTHOPEDIC (NPI# 1124286927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124286927 |
| Entity Type | Organization |
| Organization Name | FOOTCO ORTHOPEDIC |
| Practice Address |
3723 N Southport Ave Chicago IL 60613-3718 |
| Mailing Address |
Po Box 13377 Chicago IL 60613-0377 |
| Practice Telephone | 3124092175 |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-05-28 |
| Authorized Official Name | TIM PORCELLI (DIRECTOR, CHIEF CLINICIAN) |
| Authorized Official Telephone | 3124092175 |
| Authorized Official Credential | LC PED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
212.000115 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 1670909 | 01 |
| Street Address |
3723 N SOUTHPORT AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60613-3718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437477742 | Cloud Gate Acupuncture | Clinic/Center | 3723 N Southport Ave, Chicago, IL 60613-3718 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261978 | Thorek Radiology Group Nfp | Radiology | 850 West Irving Park Road, Chicago, IL 60613 | 2020-10-08 |
| 1760034128 | Maryellen Karas Lajeunesse | Social Worker | 3930 N. Pine Grove Ave, #2403, Chicago, IL 60613 | 2019-07-15 |
| 1801366430 | Stephanie A Dykema | Psychologist | 4043 N Ravenswood Ave Suite 302, Chicago, IL 60613 | 2018-11-27 |
| 1487154191 | Alan Tsang | Counselor | 655 W Irving Park Rd Ste 203, Chicago, IL 60613 | 2018-02-19 |
| 1972015782 | Integrated Ortho, LLC. | Durable Medical Equipment & Medical Supplies | 3717 N. Ravenswood Ave, Suite 219w, Chicago, IL 60613 | 2017-11-02 |
| 1073048005 | Claire Jolly | Social Worker | 3701 N Ravenswood Ave Ste 301, Chicago, IL 60613 | 2017-04-27 |
| 1730626011 | Marc Fagan | Psychologist | 4101 N Ravenswood Ave., Chicago, IL 60613 | 2017-01-25 |
| 1205385671 | Sara Turner | Psychologist | 3855 N Greenview Ave # 2a, Chicago, IL 60613 | 2016-09-27 |
| 1962955997 | Michelle Montero | Psychologist | 925 W Dakin St Apt 405, Chicago, IL 60613 | 2016-07-26 |
| 1063883494 | Athletico, Ltd | Physical Therapist | 3922 North Sheridan Rd, Chicago, IL 60613 | 2015-10-12 |
| Find all providers in zip 60613 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528509833 | International Medical Equipment Distributors LLC | Durable Medical Equipment & Medical Supplies | 8501 W Higgins Rd Ste 710, Chicago, IL 60631-2883 | 2017-03-20 |
| 1851785224 | Floss Dental Studio PC | Durable Medical Equipment & Medical Supplies | 924 N Damen Ave, Chicago, IL 60622-4948 | 2015-03-24 |
| 1972926012 | Mts Direct Inc | Durable Medical Equipment & Medical Supplies | 4734 S Prairie Ave Unit 1, Chicago, IL 60615-1206 | 2014-01-24 |
| 1659501500 | The Board of Trustees of The University of Illinois | Durable Medical Equipment & Medical Supplies | 811 S Paulina St, 118 Dent, Mc 588, Chicago, IL 60612-4353 | 2009-07-24 |
| 1053549402 | Crowning Glory Lace Wigs | Durable Medical Equipment & Medical Supplies | 8100 S Stony Island Ave, Unit F, Chicago, IL 60617-1734 | 2009-06-24 |
| 1528250669 | Premier Podiatry Services, Ltd | Durable Medical Equipment & Medical Supplies | 6374 N Lincoln Ave Ste 303, Chicago, IL 60659-1283 | 2007-08-13 |
| 1083769202 | Luna Medical Inc. | Durable Medical Equipment & Medical Supplies | 1057 W Grand Ave Ste 1, Chicago, IL 60642-6600 | 2007-01-25 |
| 1629146014 | Kreg Therapeutics, Inc. | Durable Medical Equipment & Medical Supplies | 2240 W Walnut St, Chicago, IL 60612-2218 | 2006-12-01 |
| 1568417319 | Absolute Medical, Inc. | Durable Medical Equipment & Medical Supplies | 1843 W Hubbard St, Suite 2a, Chicago, IL 60622-6236 | 2006-05-23 |
| 1457897332 | Maria Therese Galang Dmd Ms P C | Durable Medical Equipment & Medical Supplies | 111 N Wabash Ave, Ste 1522, Chicago, IL 60602 | 2017-01-16 |
| Find all providers in CHICAGO | ||||
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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.