Provider Demographics
NPI:1598753949
Name:ESPOSITO, RALPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 W CHESTNUT ST STE 220
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3175
Mailing Address - Country:US
Mailing Address - Phone:630-908-7163
Mailing Address - Fax:
Practice Address - Street 1:534 W CHESTNUT ST STE 220
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3175
Practice Address - Country:US
Practice Address - Phone:630-908-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005224213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016005224Medicaid
ILK20342Medicare ID - Type UnspecifiedMEMBER NUMBER
0224260001Medicare NSC
IL6712380001Medicare UPIN
P00336624Medicare PIN
IL6712380001Medicare PIN
IL016005224Medicaid