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FOX LAKE FOOT CARE LTD
NPI 1699053967
Podiatrist - Foot & Ankle Surgery in Ingleside, IL

Active since August 03, 2011CLIA 14D2032112 · Waiver
214 WASHINGTON ST, SUITE #3, INGLESIDE, IL 60041(847) 587-3221(847) 587-2148 Get Directions Write a Review

NPPES record last updated: August 3, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Fox Lake Foot Care Ltd NPPES

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

FOX LAKE FOOT CARE LTD (NPI 1699053967) is a healthcare organization registered as a foot & ankle surgery in Ingleside, Illinois and active in the NPI registry since August 2011. The organization holds a CLIA Waiver certificate valid through November 3, 2027 and lists Tegan A Thimesch, Doctor, as its authorized official.

NPPES Registry Identity

NPI1699053967
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameFOX LAKE FOOT CARE LTD
Location Address214 WASHINGTON ST, SUITE #3Ingleside, IL 60041-9208
Mailing Address214 Washington St, Suite #3Ingleside, IL 60041-9208 · (847) 587-3221 · Fax (847) 587-2148
Phone(847) 587-3221
Fax(847) 587-2148
Organization SubpartNo
Authorized OfficialTegan A ThimeschDoctor · (847) 587-3221
Enumeration DateAugust 3, 2011
✔ NPI 1699053967 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 · 016003998
214 WASHINGTON ST, Ingleside, IL 60041
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fox Lake Foot Care Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fox Lake Foot Care Ltd, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tegan Thimesch, DPM
Podiatry
NPI 1376511287
4040 W PETERSON AVE
Chicago, IL 60646
(773) 267-0554
✔ PECOS✔ Accepts Medicare35 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2032112

Fox Lake Foot Care Ltd · Ingleside, IL
Active · expires Nov 3, 2027
CLIA Number14D2032112
Laboratory TypePhysician Office
Certificate Effective DateNovember 4, 2025
Certificate Expiration DateNovember 3, 2027
Laboratory DirectorTegan A. Thimesch Dpm
Laboratory Phone(847) 587-3221
Laboratory LocationFox Lake Foot Care Ltd214 Washington St Ste 3, Ingleside, IL 60041
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Fox Lake Foot Care Ltd's NPI number?

The NPI number for Fox Lake Foot Care Ltd is 1699053967. It was assigned to this organization in the NPPES registry on August 3, 2011.

Where is Fox Lake Foot Care Ltd located?

Fox Lake Foot Care Ltd is located at 214 Washington St Suite #3, Ingleside, IL 60041. The listed phone number is (847) 587-3221.

What is Fox Lake Foot Care Ltd's specialty?

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

Is Fox Lake Foot Care Ltd enrolled in Medicare?

Yes. Fox Lake Foot Care Ltd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fox Lake Foot Care Ltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Fox Lake Foot Care Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Fox Lake Foot Care Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2032112) is associated with this NPI, valid through November 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fox Lake Foot Care Ltd was last updated on August 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.