Provider Demographics
NPI:1598766602
Name:WINTERS, GRIFF J (DPM)
Entity Type:Individual
Prefix:DR
First Name:GRIFF
Middle Name:J
Last Name:WINTERS
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 1:770 N STATE ROUTE 83
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1330
Mailing Address - Country:US
Mailing Address - Phone:847-223-4000
Mailing Address - Fax:847-223-9171
Practice Address - Street 1:770 BARRON BLVD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1330
Practice Address - Country:US
Practice Address - Phone:847-223-4000
Practice Address - Fax:847-223-9171
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL316000982213E00000X
IL016-003420213ES0000X, 213E00000X
IL016003420213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37946Medicare UPIN
IL696310Medicare ID - Type Unspecified