Provider Demographics
NPI:1942334404
Name:FIRST STEP FOOT CARE, SC
Entity type:Organization
Organization Name:FIRST STEP FOOT CARE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-487-2827
Mailing Address - Street 1:9400 S CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2536
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:385 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-2424
Practice Address - Country:US
Practice Address - Phone:847-487-2827
Practice Address - Fax:847-487-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004254Medicaid
IL950390Medicare PIN
IL632600Medicare PIN
IL016004254Medicaid