Active NPI
Colleen Finlay
- Dentist
- Lake in the Hills, IL
National Provider Identifier
1063809382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019030392
- Practice address
- 152 N Randall Rd
Lake in the Hills, IL 60156-4471 - Phone
- (847) 854-8555
- NPI assigned
- Apr 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019030392 | IL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
152 N Randall Rd
Lake in the Hills, IL 60156-4471
Mailing address
152 N Randall Rd
Lake in the Hills, IL 60156-4471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160428001978 | IL | Order and Referring Only - Oral Surgery | 1759680549 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019030392 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carron and Hodack Dental Associates LLC | Past | Accepting new patients |
Interoperability endpoints
- cfinlay646314@direct.ochin.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Lake in the Hills, IL
- NPI 1740407410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451692800000",
"number": "1063809382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 N RANDALL RD",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "601564471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 N RANDALL RD",
"city": "LAKE IN THE HILLS",
"state": "IL",
"postal_code": "601564471",
"telephone_number": "847-854-8555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINLAY",
"first_name": "COLLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-24",
"last_updated": "2016-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019030392",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake in the Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.