DCP of Illinois - Crystal Lake

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DCP OF ILLINOIS - CRYSTAL LAKE

Practice address

1145 South Route 31
Siute J
Crystal Lake, IL 60039

Phone

(815) 477-5399

Fax

(815) 477-2593

NPI assigned

Apr 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lauren Hill

Title

RCM, Director

Phone

(972) 930-7707

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Loretta Davis

  • General Practice Dentistry
  • Elgin, IL
  • NPI 1144391855
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1003089251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 LANDERBROOK DR",
            "address_2": "#250",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246511",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SOUTH ROUTE 31",
            "address_2": "SIUTE J",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60039",
            "telephone_number": "815-477-5399",
            "fax_number": "815-477-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCP OF ILLINOIS - CRYSTAL LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "RCM, DIRECTOR",
        "authorized_official_telephone_number": "972-930-7707"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle David
• April Leigh Davidson, BA, DT
• Elijah Davidson
• Seir Fen Davidson, PHARMD
• Ryan James Davis, LMFT, ATR
• Catherine Dean, PSYD
• Linda Deanda
• Julia Deatherage
• Debra K.Hirschberg and Associates, Inc.
• Stacy Decristofaro, DT

• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.