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

Ersta Putra Ferryanto, DPM

Individual provider Podiatrist · NPI 1588243984

Ersta Putra Ferryanto, DPM is a Podiatry in Glenview, Illinois. Graduated from College of Podiatric Med and Surgery, Des Moines University in 2021, 5 years ago. Practices with Elevate Active Health PLLC, a 2-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Trained at
College of Podiatric Med and Surgery, Des Moines University
Licensed in
IL
In the registry since
2021
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

2200 Waukegan Rd Ste Fgh
Glenview, IL 60025-1759
Phone: (847) 558-7670
Fax: (888) 202-3110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 016006049 (IL)

Record details

NPI number1588243984
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedApril 5, 2021
Last updated in NPPESFebruary 23, 2026
Certification dateFebruary 23, 2026
Mailing address2200 Waukegan Rd Ste Fgh, Glenview, IL 60025-1759

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolCOLLEGE OF PODIATRIC MED AND SURGERY, DES MOINES UNIVERSITY
Graduated 2021 (5 years in practice)
Group practice Elevate Active Health Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Glenview