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LIBERTYVILLE ANKLE & FOOT CLINIC, INC
NPI 1487630406
Podiatrist - Foot & Ankle Surgery in Libertyville, IL

Active since December 21, 2005
1017 W PARK AVE, SUITE A, LIBERTYVILLE, IL 60048(847) 362-1320(847) 362-1823 Get Directions Write a Review

NPPES record last updated: July 25, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Libertyville Ankle & Foot Clinic, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIBERTYVILLE ANKLE & FOOT CLINIC, INC (NPI 1487630406) is a healthcare organization registered as a foot & ankle surgery in Libertyville, Illinois and active in the NPI registry since December 2005. The organization lists Scott A Jacobsen, Owner, as its authorized official.

NPPES Registry Identity

NPI1487630406
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameLIBERTYVILLE ANKLE & FOOT CLINIC, INC
Location Address1017 W PARK AVE, SUITE ALibertyville, IL 60048-2502
Mailing Address1017 W Park Ave, Suite ALibertyville, IL 60048-2502 · (847) 362-1320 · Fax (847) 362-1823
Phone(847) 362-1320
Fax(847) 362-1823
Organization SubpartNo
Authorized OfficialScott A JacobsenOwner · (847) 362-1320
Enumeration DateDecember 21, 2005
Last NPPES UpdateJuly 25, 2014
✔ NPI 1487630406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in IL · 016-005031
1017 W PARK AVE, Libertyville, IL 60048
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Other Identifiers 6

Other04932511IL · Bluecross
Medicare UPINU90921
Medicare NSC4302510001IL
OtherP00347050IL · Railroad Medicare
Medicaid016005031IL
Medicare PIN213648IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL THOMAS SHOEMAKE
Clinic/Center (Physical Therapy)
1017 W PARK AVE, SUITE B
LIBERTYVILLE, IL 60048
Lake County (847) 997-0650
MICHAEL SHOEMAKE PT
Physical Therapist
1017 W PARK AVE, SUITE B
LIBERTYVILLE, IL 60048
Lake County (847) 996-0650

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Libertyville Ankle & Foot Clinic, Inc's NPI number?

The NPI number for Libertyville Ankle & Foot Clinic, Inc is 1487630406. It was assigned to this organization in the NPPES registry on December 21, 2005.

Where is Libertyville Ankle & Foot Clinic, Inc located?

Libertyville Ankle & Foot Clinic, Inc is located at 1017 W Park Ave Suite A, Libertyville, IL 60048. The listed phone number is (847) 362-1320.

What is Libertyville Ankle & Foot Clinic, Inc's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Libertyville Ankle & Foot Clinic, Inc was last updated on July 25, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.