Individual provider Active NPI

Katie Elizabeth Limardi, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1053606475
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028618 Issued in IL
Practice address
811 W Wellington Ave
Advocate Illinois Masonic Medical Center
Chicago, IL 60657-5123
Phone
(773) 871-1461
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028618 IL Primary

Addresses

Primary practice location

811 W Wellington Ave
Advocate Illinois Masonic Medical Center
Chicago, IL 60657-5123

Mailing address

1307 S Wabash Ave
#602
Chicago, IL 60605-2620
Phone (847) 452-3886

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
019028618ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1053606475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 S WABASH AVE",
            "address_2": "#602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052620",
            "telephone_number": "847-452-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W WELLINGTON AVE",
            "address_2": "ADVOCATE ILLINOIS MASONIC MEDICAL CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575123",
            "telephone_number": "773-871-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIMARDI",
        "first_name": "KATIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028618",
            "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 Jun 14, 2011; 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.