LIBERTYVILLE PODIATRY
NPI 1639969645
Podiatrist - Foot & Ankle Surgery in Libertyville, IL
NPI Status: Active since May 12, 2025
Contact Information
1870 W WINCHESTER RD STE 246
LIBERTYVILLE, IL
ZIP 60048
Phone: (847) 816-3156
Fax: (847) 816-9724
- Organization
- Podiatrist
- Foot & Ankle Surgery
- CLIA Number: 14D0674905
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 08-20-2026
About LIBERTYVILLE PODIATRY
This page provides the complete NPI Profile along with additional information for Libertyville Podiatry, a provider established in Libertyville, Illinois operating as a Podiatrist, focusing in foot & ankle surgery . The healthcare provider is registered in the NPI registry with number 1639969645 assigned on May 2025. The practitioner's primary taxonomy code is 213ES0103X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Daniel Surowiec Dpm (Owner/physician)
- NPI
- 1639969645
- Provider Name
- LIBERTYVILLE PODIATRY
- Entity Type
- Organization
- Location Address
- 1870 W WINCHESTER RD STE 246 LIBERTYVILLE, IL 60048
- Location Phone
- (847) 816-3156
- Location Fax
- (847) 816-9724
- Mailing Address
- 1870 W WINCHESTER RD STE 246 LIBERTYVILLE, IL 60048
- Mailing Phone
- (847) 816-3156
- Mailing Fax
- (847) 816-9724
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-12-2025
- Last Update Date
- 05-12-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Podiatrist Foot & Ankle Surgery
- Taxonomy Code
- 213ES0103X
- Type
- Podiatric Medicine & Surgery Service Providers
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0674905
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- August 21, 2024
- Certificate Expiration Date
- August 20, 2026
- Laboratory Director
- JOHN STOKOVICH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Libertyville Podiatry to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1639969645, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 85. The final step is to find the difference between that total and the next multiple of ten (90 - 85 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 85 is 90. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
LIBERTYVILLE, IL 60048
LIBERTYVILLE, IL 60048
LIBERTYVILLE, IL 60048
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639969645, enumerated as an "organization" on May 12, 2025.
The provider is located at 1870 W WINCHESTER RD STE 246 LIBERTYVILLE, IL 60048 and the phone number is (847) 816-3156.
Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.
