Individual provider Active NPI

Nicholas Callahan, MPH DMD MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Chicago, IL
National Provider Identifier
1083920227
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
036147058 Issued in IL
Practice address
801 S Paulina St
Chicago, IL 60612
Phone
(312) 413-2379
Fax
(312) 996-5987
NPI assigned
Aug 25, 2010
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 021102880 IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 036147058 IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019031599 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021002880 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 036147058 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019031599 IL
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 036147058 IL Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 019031599 IL
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 021002880 IL

Addresses

Primary practice location

801 S Paulina St
Chicago, IL 60612

Mailing address

801 S Paulina St
Chicago, IL 60612-7210
Phone (312) 413-2379

Other practice location 1

451 Clarkson Ave
Dental Clinic
Brooklyn, NY 11203-2054
Phone (718) 245-4914

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015002575 IL Practitioner - Maxillofacial Surgery 7012202864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
State University of New York Downstate Medical Center, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1855 W Taylor St
Chicago, IL 60612-7242
Phone (312) 996-6590

801 S Paulina St
Chicago, IL 60612-7210
Phone (312) 996-7532

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021102880ILMDOral and Maxillofacial Surgery (Dentist)
019031599ILMDOrthodontics and Dentofacial Orthopedic Dentist
036147058ILMDOrthodontics and Dentofacial Orthopedic Dentist
021002880ILMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 25, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois Oral and Maxillofacial Surgery CurrentSince Aug 25, 2018 Accepting new patients
The Board of Trustees of the University of Illinois PastSince Jan 19, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

801 S Paulina St
Chicago, IL 60612
Phone (312) 996-1052

801 S Paulina St
#621
Chicago, IL 60612
Phone (312) 355-1661

Interoperability endpoints

  • Direct secure messaging: ncallahan276330@direct.myadvocateaurora.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1083920227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-413-2379",
            "fax_number": "312-996-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-413-2379",
            "fax_number": "312-996-5987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Clarkson Ave",
            "address_2": "Dental Clinic",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032054",
            "country_code": "US",
            "telephone_number": "718-245-4914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MPH DMD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021102880",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "036147058",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019031599",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021002880",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "036147058",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019031599",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "036147058",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "019031599",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "021002880",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.