Individual provider Active NPI

Karen Davida Fields, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1053567214
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019027779 Issued in IL
Practice address
430 W Erie St
Suite 200
Chicago, IL 60654-6914
Phone
(920) 838-1649
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019027779 IL Primary

Addresses

Primary practice location

430 W Erie St
Suite 200
Chicago, IL 60654-6914

Mailing address

430 W Erie St
Suite 200
Chicago, IL 60654-6914
Phone (920) 838-1649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019027779ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1053567214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546914",
            "telephone_number": "920-838-1649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546914",
            "telephone_number": "920-838-1649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "KAREN",
        "middle_name": "DAVIDA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.