MEDICARE: BRIAN ANDREW OPENSKY DPM

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	213E00000X	Podiatrist	07000977A	IN
2	213EP1101X	Primary Podiatric Medicine Podiatrist	016005221	IL
3	213EP1101X	Primary Podiatric Medicine Podiatrist	07000977A	IN
4	213EP0504X	Public Medicine Podiatrist	016005221	IL
5	213EP0504X	Public Medicine Podiatrist	07000977A	IN
6	213ES0103X	Foot & Ankle Surgery Podiatrist	016005221	IL
7	213ES0103X	Foot & Ankle Surgery Podiatrist	07000977A	IN
8	213ES0131X	Foot Surgery Podiatrist	07000977A	IN
9	213ES0131X	Foot Surgery Podiatrist	016005221	IL
10	213E00000X	Podiatrist	016005221	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00002479469 06	OTHER	IL	UNITED HEALTHCARE
2	7785640	OTHER	IL	AETNA
3	000000341268	OTHER	IN	ANTHEM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477559466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN ANDREW OPENSKY DPM

Provider Business Mailing Address
First Line	:	6225 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2818
Country	:	US
Telephone Number	:	708-747-8994
Fax Number	:	847-965-6325

Provider Business Practice Location Address
First Line	:	6225 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2818
Country	:	US
Telephone Number	:	708-747-8994
Fax Number	:	708-747-0170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	12/06/2024

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Directions to “ BRIAN ANDREW OPENSKY DPM” Practice Location

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