Active NPI
Amelia K Angelo, DMD
- Pediatric Dentistry
- Chicago, IL
National Provider Identifier
1104317510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 021003052
- Practice address
- 6036 N Northwest Hwy
Chicago, IL 60631-2518 - Phone
- (773) 377-5658
- NPI assigned
- May 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | PENDING | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | IL | ||
| Pediatric Dentistry | 1223P0221X | 021003052 | IL | Primary |
Addresses
Primary practice location
6036 N Northwest Hwy
Chicago, IL 60631-2518
Mailing address
PO Box 915
Park Ridge, IL 60068-0915
Phone (847) 845-3473
Other practice location 1
467 W Deming Pl
Chicago, IL 60614-1881
Phone (847) 845-3473
Other practice location 2
225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-4000
Other names 1
- Mrs. Amelia Angelo-Ori
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
225 E Chicago Ave
Chicago, IL 60611-2991
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021003052 | IL | MD | Pediatric Dentist |
| PENDING | IL | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sprout Pediatric Dentistry | Dentist | Past | Accepting new patients |
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.
-
- Dentist
- Chicago, IL
- NPI 1538512884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613001600000",
"number": "1104317510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 915",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600680915",
"telephone_number": "847-845-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6036 N NORTHWEST HWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606312518",
"telephone_number": "773-377-5658"
}
],
"practiceLocations": [
{
"address_1": "467 W Deming Pl",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606141881",
"country_code": "US",
"telephone_number": "847-845-3473",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "225 E Chicago Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60611",
"country_code": "US",
"telephone_number": "312-227-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANGELO",
"first_name": "AMELIA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "PENDING",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021003052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMELIA",
"last_name": "ANGELO-ORI",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}
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 11, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.