PERFORMANCE FOOT AND ANKLE CENTER LLC (NPI# 1750397428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750397428 |
| Entity Type | Organization |
| Organization Name | PERFORMANCE FOOT AND ANKLE CENTER LLC |
| Practice Address |
401 E 162nd St Suite 101 South Holland IL 60473-2236 |
| Practice Telephone | 7085963757 |
| Practice Fax Number | 7085963779 |
| Mailing Telephone | 7085963757 |
| Mailing Fax Number | 7085963779 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-07-16 |
| Authorized Official Name | DR. DALE STEVEN BRINK (DOCTOR) |
| Authorized Official Telephone | 7085963757 |
| Authorized Official Credential | DPM, FACFAS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 5000520001 | IL | Suppliers |
| Y | 213E00000X | Podiatrist | ========= | IL | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104004290 | Performance Foot and Ankle Center LLC | Durable Medical Equipment & Medical Supplies | 15300 West Ave, Suite 210, Orland Park, IL 60462-4600 | 2008-01-31 |
| Street Address |
401 E 162ND ST SUITE 101 |
| City | SOUTH HOLLAND |
| State | IL |
| Zip Code | 60473-2236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336631662 | Genaea Marie Carson | Counselor | 401 E 162nd St, South Holland, IL 60473 | 2018-06-01 |
| 1063904597 | Sherrice A Hoffman | Counselor | 401 E 162nd St, South Holland, IL 60473-2236 | 2018-05-31 |
| 1194165357 | Vivek Patel | Podiatrist | 401 E 162nd St, Suite 101, South Holland, IL 60473-2236 | 2013-07-02 |
| 1881725141 | Ronald J. Waryjas, Dds, Ltd.ar | Dentist | 401 E 162nd St, Suite 205, South Holland, IL 60473-2236 | 2007-03-08 |
| 1457482796 | Ronald J. Waryjas | Dentist | 401 E 162nd St, Suite 205, South Holland, IL 60473-2236 | 2007-03-08 |
| 1013064328 | Byron Waller | Counselor | 401 E 162nd St, Suite 109, South Holland, IL 60473-2236 | 2007-01-05 |
| 1881760593 | Refuge Christian Counseling | Counselor | 401 E 162nd St, Suite 109, South Holland, IL 60473-2237 | 2006-11-27 |
| 1942376652 | Steven R Hoekstra | Counselor | 401 E 162nd St, Suite 109, South Holland, IL 60473-2237 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558826453 | Beverly Hadley, Dds P.C. | Dentist | 16282 Prince Drive, South Holland, IL 60473 | 2019-02-05 |
| 1053830828 | Caring Shepherds Health Care Inc | In Home Supportive Care | 15525 South Park Ave, Suite 103b, South Holland, IL 60473 | 2017-09-13 |
| 1972039469 | Dipeeka Patel | Nurse Practitioner | 430 E 162nd St # 487, South Holland, IL 60473 | 2017-05-03 |
| 1134576036 | A&j Transportation LLC | Non-emergency Medical Transport (VAN) | 16610 Langley Ave, South Holland, IL 60473 | 2016-05-20 |
| 1902204902 | Np Prn LLP | Clinic/Center | 16456 Dobson, South Holland, IL 60473 | 2014-12-08 |
| 1033415328 | Twfj Inc | Private Vehicle | 15059 Forestview, South Holland, IL 60473 | 2011-02-03 |
| 1871751396 | Arlene Gardner | Counselor | 16107 Lasalle Street, South Holland, IL 60473 | 2008-05-30 |
| 1952576233 | Harvey Family Center | Voluntary or Charitable | 16247 Wausau Ave., South Holland, IL 60473 | 2008-04-28 |
| 1548452725 | Chirospaaah | Chiropractor | 944 East 162nd St., South Holland, IL 60473 | 2007-08-13 |
| 1033313341 | Myra D Staples | Social Worker | 430 East 167th Street, South Holland, IL 60473 | 2007-06-12 |
| Find all providers in zip 60473 | ||||
| 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 |
|---|---|---|---|---|
| 1174671333 | Brian C. Wittmayer | Podiatrist | 401 E. 162nd St, Suite 101, South Holland, IL 60473-2236 | 2007-01-06 |
| 1093722365 | Dale Steven Brink | Podiatrist | 401 E 162nd St Ste 101, South Holland, IL 60473-2237 | 2006-08-01 |
| 1104833292 | Timothy John Krygsheld | Podiatrist | 401 E 162nd St Ste 101, South Holland, IL 60473-2237 | 2006-08-01 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HOLLAND |
| Zip Code | 60473 |
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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.