{
"Npi": {
"NPI": "1336389204",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FOX VALLEY FOOT SPECIALISTS,LTD",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1279 S NAPER BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NAPERVILLE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60540-8300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-548-3900",
"MailingAddressFaxNumber": "630-548-3905",
"FirstLinePracticeLocationAddress": "1279 S NAPER BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAPERVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60540-8300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-548-3900",
"PracticeLocationAddressFaxNumber": "630-548-3905",
"EnumerationDate": "03/04/2009",
"LastUpdateDate": "10/23/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCARTHY",
"AuthorizedOfficialFirstName": "BRENDON",
"AuthorizedOfficialMiddleName": "J.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.M.",
"AuthorizedOfficialTelephoneNumber": "630-548-3900",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "060-007904",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "060-007904",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}