NPIMap

Organization Active NPI

Charles Lockhart DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1053602227
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019014618 Issued in IL
Legal business name
CHARLES LOCKHART DDS
Practice address
150 E Huron St
Suite 1103
Chicago, IL 60611-2999
Phone
(312) 676-9893
Fax
(815) 744-7059
NPI assigned
Apr 22, 2011
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Scott D Craig, CEO
Title
Ceo
Phone
(312) 676-9893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019014618 IL Primary

Addresses

Primary practice location

150 E Huron St
Suite 1103
Chicago, IL 60611-2999

Mailing address

4748 N Milwaukee Ave Ste 1
Chicago, IL 60630-3617
Phone (773) 685-9339

Other identifiers 1

IdentifierTypeStateIssuer
1457579682OtherTYPE 1 INDIVIDUAL NPI

National Provider Directory

National Provider Directory
Tax ID family
Dental Sleep Center Richard7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4748 N Milwaukee Ave
Ste 1
Chicago, IL 60630
Phone (773) 685-9339

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1053602227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4748 N MILWAUKEE AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303617",
            "telephone_number": "773-685-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-676-9893",
            "fax_number": "815-744-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES LOCKHART DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2023-02-08",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-676-9893",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019014618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 INDIVIDUAL NPI",
            "identifier": "1457579682",
            "state": null
        }
    ],
    "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 Feb 8, 2023; 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.