NWDG Niles LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019020600 Issued in IL

Legal business name

NWDG NILES LLC

Practice address

7886 N Milwaukee Ave
Niles, IL 60714-3145

Phone

(847) 423-2488

Fax

(847) 423-2492

NPI assigned

Feb 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence Mulvaney, D.D.S.

Title

Sole Member

Phone

(847) 423-2488

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1093089690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7886 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143145",
            "telephone_number": "847-423-2488",
            "fax_number": "847-423-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7886 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143145",
            "telephone_number": "847-423-2488",
            "fax_number": "847-423-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NWDG NILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "MULVANEY",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "847-423-2488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.