Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Grant Wilson Gonzalez, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1164856704

Dr. Grant Wilson Gonzalez, DPM is a Podiatry in Springfield, Illinois. Qualified in 2012, 14 years ago. Practices with Foot and Ankle Center of Illinois PC, a 2-clinician group and accepts Medicare assignment. Licensed in Georgia and Illinois.

Years since qualifying
14
Licensed in
GA, IL
In the registry since
2013
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

2921 Montvale Dr
Springfield, IL 62704-5359
Phone: (217) 787-2700
Fax: (217) 787-2715
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 016005651 (IL)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence POD001231 (GA)

Record details

NPI number1164856704
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedAugust 31, 2013
Last updated in NPPESMarch 7, 2023
Certification dateApril 14, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Foot And Ankle Center Of Illinois Pc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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