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

Q: 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.

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: August 16, 2026.

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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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.