NPIMap

Organization Active NPI

Oak Brook Dental Affiliates P.C.

  • Dentist
  • Oak Brook, IL
National Provider Identifier
1023445186
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19012052 Issued in IL
Legal business name
OAK BROOK DENTAL AFFILIATES P.C.
Practice address
120 Oakbrook Center Mall
Suite 510
Oak Brook, IL 60523-1806
Phone
(630) 571-0393
NPI assigned
Oct 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Authorized official

Name
Dr. James B Chidester
Title
Owner
Phone
(630) 571-0393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19012052 IL Primary

Addresses

Primary practice location

120 Oakbrook Center Mall
Suite 510
Oak Brook, IL 60523-1806

Mailing address

120 Oakbrook Center Mall
Suite 510
Oak Brook, IL 60523-1806
Phone (630) 571-0393

National Provider Directory

National Provider Directory

Locations

120 Oakbrook Ctr
Ste 510
Oak Brook, IL 60523
Phone (630) 571-0393

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1023445186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OAKBROOK CENTER MALL",
            "address_2": "SUITE 510",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806",
            "telephone_number": "630-571-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OAKBROOK CENTER MALL",
            "address_2": "SUITE 510",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806",
            "telephone_number": "630-571-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK BROOK DENTAL AFFILIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "CHIDESTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-571-0393",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "19012052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.