PREMIER FOOT AND ANKLE OF ILLINOIS, PC – Foot & Ankle Surgery Podiatrist, NPI 1467867234

PREMIER FOOT AND ANKLE OF ILLINOIS, PC is a healthcare provider. based in Maryville, Illinois. specializing in Foot & Ankle Surgery Podiatrist. The organization holds a License No. 016.005608 (IL). The NPI Number for PREMIER FOOT AND ANKLE OF ILLINOIS, PC is 1467867234

Main info

Organization
Name
PREMIER FOOT AND ANKLE OF ILLINOIS, PC
NPI
1467867234
Phone
(618) 288-2835
Address
6810 STATE ROUTE 162
Authorized Official
DR. GABRIEL CARDENAS JR. OWNER/PODIATRIST DPM
Enumeration Date
30 June 2014
Last Update Date
18 November 2016
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for PREMIER FOOT AND ANKLE OF ILLINOIS, PC

  • 6810 STATE ROUTE 162

    SUITE 20

    MARYVILLE, IL 620628587

    Phone: (618) 288-2835

    Fax: (618) 288-6162

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-08-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20140801001280OClinic/Group PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62062)

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Reviews

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Frequently asked questions

What is the registry number for PREMIER FOOT AND ANKLE OF ILLINOIS, PC?
The registry entry for PREMIER FOOT AND ANKLE OF ILLINOIS, PC shows NPI 1467867234.
Is PREMIER FOOT AND ANKLE OF ILLINOIS, PC's NPI status active today?
Active status means PREMIER FOOT AND ANKLE OF ILLINOIS, PC's NPI record is not deactivated in the public file.
What services align with PREMIER FOOT AND ANKLE OF ILLINOIS, PC's listing?
PREMIER FOOT AND ANKLE OF ILLINOIS, PC's public classification highlights Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What city is tied to PREMIER FOOT AND ANKLE OF ILLINOIS, PC?
The directory associates PREMIER FOOT AND ANKLE OF ILLINOIS, PC with Maryville, Illinois. Check all listed addresses for suites or satellite offices.
Can I export PREMIER FOOT AND ANKLE OF ILLINOIS, PC's record?
You can download the official NPPES record; we summarize key fields for readability.

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