MEDICARE: DM FOOT AND ANKLE ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	016.005312	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3285216	OTHER	IL	CIGNA
2	01638062	OTHER	IL	BLUE CROSS BLUE SHIELD
3	01638062	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1912190349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DM FOOT AND ANKLE ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	9400 S CICERO AVE STE 100
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-2536
Country	:	US
Telephone Number	:	708-424-3201
Fax Number	:	708-424-5001

Provider Business Practice Location Address
First Line	:	14236 MCCARTHY RD
Second Line	:
City	:	LEMONT
State	:	IL
Zip	:	60439-9393
Country	:	US
Telephone Number	:	630-863-7517
Fax Number	:	630-863-7519

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. DIANA M EMINI
Credential	:	DPM
Telephone Number	:	630-863-7517

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	12/02/2025

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