OPENSKY, BRIAN ANDREW (DPM)

Provider Demographics

• NPI: 1477559466
• Name: OPENSKY, BRIAN ANDREW (DPM)
• Entity Type: Individual
• First Name: BRIAN
• Middle Name: ANDREW
• Last Name: OPENSKY
• Gender: M
• Credentials: DPM
• Mailing Address - Street 1: 2601 LINCOLN HWY
• Mailing Address - Street 2: STE 102
• Mailing Address - City: OLYMPIA FIELDS
• Mailing Address - State: IL
• Mailing Address - Zip Code: 60461-1862
• Mailing Address - Country: US
• Mailing Address - Phone: 708-747-8994
• Mailing Address - Fax: 708-747-0170
• Practice Address - Street 1: 2601 LINCOLN HWY
• Practice Address - Street 2: STE 102
• Practice Address - City: OLYMPIA FIELDS
• Practice Address - State: IL
• Practice Address - Zip Code: 60461-1862
• Practice Address - Country: US
• Practice Address - Phone: 708-747-8994
• Practice Address - Fax: 708-747-0170
• Is Sole Proprietor?: No
• Enumeration Date: 2005-06-23
• Last Update Date: 2021-12-21

Provider Licenses

State	License ID	Taxonomies
IN	07000977A	213E00000X, 213EP0504X, 213EP1101X, 213ES0103X, 213ES0131X
IL	016005221	213EP0504X, 213EP1101X, 213ES0103X, 213ES0131X, 213E00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	213E00000X	Podiatric Medicine & Surgery Service Providers	Podiatrist
No	213EP0504X	Podiatric Medicine & Surgery Service Providers	Podiatrist	Public Medicine
No	213EP1101X	Podiatric Medicine & Surgery Service Providers	Podiatrist	Primary Podiatric Medicine
No	213ES0103X	Podiatric Medicine & Surgery Service Providers	Podiatrist	Foot & Ankle Surgery
No	213ES0131X	Podiatric Medicine & Surgery Service Providers	Podiatrist	Foot Surgery

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	200-418510	Medicaid
IN	000000341268	Other	ANTHEM
IL	00002479469 06	Other	UNITED HEALTHCARE
IL	7785640	Other	AETNA
IL	00002479469 06	Other	UNITED HEALTHCARE
IN	1477559466	Medicare PIN
IN	DA4713	Medicare PIN
IN	000000341268	Other	ANTHEM
	5007670004	Medicare NSC
IN	5007670003	Medicare NSC
IN	V01462	Medicare UPIN
	5007670001	Medicare NSC