Provider Demographics
NPI:1710921382
Name:KANE, JOHN F (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:KANE
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 1:3936 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2732
Mailing Address - Country:US
Mailing Address - Phone:773-685-3933
Mailing Address - Fax:773-685-2416
Practice Address - Street 1:3936 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2732
Practice Address - Country:US
Practice Address - Phone:773-685-3933
Practice Address - Fax:773-685-2416
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000475246ZC0007X
IL016003376213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37839Medicare UPIN
ILL70849Medicare ID - Type UnspecifiedGROUP PRACTICE MEDICARE